HomeMy WebLinkAbout30122-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30094 Dater 03/17/04
THIS CERTIFIES that the building ADDITION
Location of Property: 1855 WESTVIEW DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 107 Block 7 Lot 6
'. Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit heretofore
:filed in this office dated FEBRUARY 2.6, 2004 pursuant to which
.Building Permit No. 30122-Z dated FEBRUARY 26, 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 AS APPLIED
FOR. CONSTRUCTION CERTIFIED BY ROBERT O'BRIEN P.E. ON 3/13/.04.
The certificate is issued to JOSEPH & BARBARA ISABELLA
(OWNER)
of the aforesaid building.
. :SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A.
Authorized S' nature
"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 Md. 30122 Z Date FEBRUARY 2,6, 2004
i
Permission is hereby granted to:
JOSEPH ISABELLA
49 DARTMOUTH STREET
ROCKVILLE CENTRE,NY 11970
f for
CONSTRUCTION OF AN AS BUILT DECK ADDITION AS APPLIED FOR WITH
I
CERTIFICATION FROM NYS ENGINEER
at premises located at 1855 WESTVIEW DR MATTITUCK
County Tax Map No. 473889 Section 107 Block 0007 Lot No. 006
pursuant to application dated FEBRUARY 26, 2004 and approved by the
Building Inspector to expire on AUGUST 26, 2005 .
Fee $ 300 . 00
}
/
ori d i
ORIGINAL
Rev. 5/8/02
jo
Form No.6
TOWN OF SOUTHOLD R r
BUILDING DHPAR14NIENT
TOWN HALL
765-1802 tL3 ( 3
20
APPLICATION FOR CERTIFICATE OF OCCUPANCY L_
rD0 D
phis application must be filled in by typewriter or ink and submitted to the Building Department with e o u rng
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.
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$2y{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$15.00
Date.
New Construction: - Old or Pre-exist�$ing: (check one)
Location of Property: fir r_sV7//_d1l e&A 111,4-y'9iN-
House No. Street Hamlet
Owner or Owners of Property: X11/J/irz/a %GSYa�� ✓5.`�4nGG/1
Suffolk County Tax Map No 1000, Section /07 Block Lot Ag�r
Subdivision Filed Map. Lot:
Permit No. �O i D�- Date of Pemvt. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
BUILDING PERMIT EXAMINER CHECKLIST
DATE REVIEWED: c) //c%/04
APPLICANT: �c&�� DATE SUBMITTED: 6 /5L/04
SCTM#DISTRICT: 1,000, SECTION: (0`4 , BLOCK: �) , LOT: SUBDAIISION_�)��
ADDRESS: n�a�— LQ l�I� CITY: ZONINTG DISTRICT: CONFORMING? Vd
BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N
BP Z/C/0 Z- INFOBP -Z/ C/0 Z- INFO
BP -Z/C/0 Z- INF O / -Z/C/0 Z- , INFO'
SINGLE &z SEPARATE CERTIFICATION-REQUIRED NOTES: -
LOTS 40,000SF 100-24.Lot recognition.(CREATEDbefcre lune 30,I983),UNDERSIZED LOTS FROM JAN.1997 100-25.Mergar.(.A nonconforming at anytime after7/1/83
REQ. LOT.SIZEt ACT. LOT SIZE:/D?BcO REQ. LOT COV.�a � ACT. LOT COV.
REQ. FRONT k; PROP-FRONT ✓ REQ SIDE on/2j' ACT. SIDE /
REQ. REAR _PROP. REAR I REQ. HEIGHT PROR HEIGHT
PROJECT DESCRIPTION: � �i
ESTIMATED PROJECT COST: _ ARCHITECT :
WATERFRONT? UAC� DESCRIPTION:
WATERFRONT? DESCRIPTION: PANEL # FLOOD ZONE:
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH D -YFTS-or ED#): DTE: / _ PERMIT #:
TOWN SEPTIC RECEIPT: Y o
NEW YORK STATE DEC: raE-D e9/v7s YES N DTE: / PERMIT #:
SOUTHOLD TOWN TRUSTEES: YES o DTE: / _ PERMIT#:
TOWN ZONING BOARD APPROVAL: YES o DTE: / /_ PERMIT#:
TOWN PLAN. BOARD APPROVAL: YES DTE: f PERMIT#:
TOWN HISTORICAL PRE (SPLIA): YES or
NEW YORK STATE CODE COMPLIANCE PAGE : Y NO
NOTES:
i
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
1. (-SF)- SF)= SF X$ _$ +$ +$ _ $
2. ( -SF)- SF)= SF X $ _$ +$ +$ _$
3. ( SF)- L SF)= SF X $ _$ +$ +$ _ $
FINAL TOTAL: $
�.� ROBERT A'BRIEN P.E. CONSULTING ENS'.INEERIIVG SERVICES
12074 MAIN ROAD, P.O. BOX 456, LAUREL, NY 11948
631-298-S252
� 620M ;
I March 13, 2004
I
Southold Building Department
artment
Town Hall
53095 Main Road
Southold, New York 11971
Re: Permit No. 30122
Certificate of Occupancy for As-built Deck
Isabella Residence
1855 Westview Drive, Mattituck, NY
SCTM No. 1000-107-7-6
Gentlemen:
I hereby certify that the deck at the above-captioned property is structurally
sound. Further, that it was constructed in accordance with the building codes in effect
in 1978, when it was built.
Very truly yours,
6� a
Robert O'Brien P. E.
o_
P
TOWN OF SOUTHOLD N2QhOTY RkORDCARD
OWNER STREET VILLAGE DIST. SUB. LOT
FORMER OWNER N / / E ACR.
veil. k,A
f)Cb(�G(r S W i TYPE OF BUILDING
r - -
�JcICr_'. �_— PL. A € k r �/ �C ..J ar- VVOJa
RES, Lo SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMAR/K/SRs:„„ �9c�
r � n rr�
17 �1I73� ll Aa;-�� /LI• ��Cj/Cli'C /r7 ~. 1RA/a.iv.0/ .1..c..,'j. t:: 201
0o i 3�S,voo
AGE BUILDING CONDITION _
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value — — —
Acre
Tillable 1 G
Tillable 2
R
x
Tillable 3
Woodland --------- _-- -
Swampland FRONTAGE ON WATER
--
Brushland J FRONTAGE ON ROAD 7J
House Plot DEPTH i
BULKHEAD
Total - t . DOCK _„ _-
rx
COLOR
TRIM
f� B 9` 2 /6 xO ' Q Q 3 3 Foundation �� Bath Dinette
Extension Basement �u �� Floors Q d K K. -
xtension Ext. Walls Wtld� Interior Finish �r�OC LR.
Extension �'- --i_i r�l ------ —
Fire Place Q s� �' Heat DR. -
Type Roof Gabe Rooms lst Floor BR. +�
orch Recreation Room Rooms 2nd Floor FIN. B.
orch Dormer -----
- --- -------
Breezeway Driveway p
Garage -------- --------- - --- ------- i
0 30
O. B.
Tota! v ! /p
�RC?IBERT O'BIRIEN P.E. CONSULTING ENGINEERING SI�FIVICESk'
... �� 20.74 MAIN ROAD, P.O. BOX 45 :,.... , .y,.,.`631-296-5252
2 ' ., ,.
•. 6, LAUREL, NY 99948 639-298-5252
t
R ED AS NOTED
DAT B.P.# K February 13, 2004
FEE: BY: '
NOTF BUILDING CEP TMENT AT
765-1802 8 AM TO 4 PM FOR THE ZONE
FOLLOWING,INSPECTIONS; FLOOD 2O�
I. fOt31 DATION - TWO REQUIRED
I. FOFI �fl11RED CONCRETE . COMPLY WITHCHAPT "46°
2. ROUGH - FRAMING & PLUMBING FLOOD DAMAGE PREVENTION
3. INSULATION SOUTHOLD tOWt�J GODS
f 4. F6fA 60ST€IUCTION MUST
�FaOQI F 3 iISeADe artm9pt
ALL" IT,IO. ��LL MMS OF NEW
Yo TR E REMO SIBLE FOR
DES iI OR CO ISTALICTIOW ERRORS.
Re: Certificate of Occupancy for As-built Deck
Isabella Residence
1855 Westview Drive, Mattituck, NY
I
SCTM No. 1000-107-7-6
Gentlemen:
I hereby certify that the deck at the above-captioned property appears to be
I structurally sound. Further, that it was constructed in accordance with the building
nodes in effect in 1978, when it was built.
Very truly yours,
S F. p.
�Fo 40 c5z91° �,= Robert O Brien P. E.
A �a
R �
�FESSION�'
OCCUPANCY OR COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
USE IS UNLAWFUL AS R4111RED AND CONDITIONS OF
WITHOUT CERTIFICATE'; 3c,7�O D I yd' ZSA
OF OCCUPANCY o ?HoLC owe PLANNING BOARD
Sou I MOLD TOWN TRUSTEES
N.Y.S.DEC
---- --
u
i
fly
fi
L _
h-
7
-
...n
t
-
' h.—� 1}. .._...., i.e.� 4 j��-.. I �� �_� f � �•� � � 1 .��/h� ,t
1: I
..l I
t
/o R - 7- � }
or NEW
4 ysreia
�7?�YTI/"vch tij�ice-
r t
m I
ys (�,
A 05271
- ':✓3 `� GcN Ir 8
a
_e e
4Ce,
AO
� I
s
N
\ k
3rPl, ,
OF NEWAS 44r,"r
ylp.
.o-..k 6 ..z�fa✓✓d�
O ° 052�L `ay
A�OFES SIONPN'� -
r
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
j FOUNDATION 2ND [ ] INSU
I FRAMING INAL
] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS. ,
DATE 14 t INSPE
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(IST) -
�) H
i
---------------------
FOUNDATION
------------------FOUNDATION(2ND)
z
.�a
ROUGH FRAMING& y
PLUMI;ING - (�
INSULA'T'ION PER N.Y. �
STATE ENERGY CODE '
FINAL 112f, ce
ADDITIONAL COMMENTS G'g�
Z
m
x
x
d
b
y
i
i
TOWN OF'SOUaTHOLD BUILDING PERMIT APPLICATION CHECKLIST'
BUILDING DEPARTMENT Do you have or need the following,before appl�ng?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 3 sets of Building Plans
TEL: (631)765-1802 Planning Board approval
FAX: (631)765-9502 —z— Survey
www. northforknet/Southold/ PERMIT NO. ��� Check
Septic Form
N.Y.S.D.E.0
Trustees
Examined 2'6 20 7 Contact:
Approved 20 Mail to:
Disapproved a/c _
Phone:
Expiration 120
rte_
—7—Buildfiij Ixt pP�or
APPLICATIONFOR BUILDING PERIVIIT x
Date7Z" 1 20_d3
Wr
r' INSTRUCTIONS
a. This application MtST�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 Iodation of lot and of buildings on premises,relationship to adjoining premises or public streets or
areas, and waterways.
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.Na building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues 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 n,In6een completed,witbin 18 monthsfrom'such date.If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize,in writing,the extension of the permit 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 inspections.
z r-�,4 F2Awc0,5
I L Q q(Signature c applicant o name,if a corporation)
�o15 C/o
NAi A. 0`t3UCKLe"y. PC
(Mailing address of applicant)
State whether applicant is owner, lessee, agent,architect,engineer, general contractor, electrician,plumber or builder
CXECUTo/Z -ry DECe-ASEID PRic)R Du3Nxt..72
Name of owner ofPremises 'JAR5A2A Sc->.SEpm Ss6i3t-ui}
(As on the tax roll or latest deed)
I 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.
1. Location of land on which proposed work will be done:
1855" Wc_5-7yieV Doawr P,`t-sITUCK
House Number Street Hamlet
County Tax Map No. 1000 Section j O Block 7 Lot
Subdivision Filed Map No. Lot
(Name)
i
2. 'Sytate ekisting use and eccupaney.of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 51N6t,6 FAMI (. i2t 5iDc--Nee- ` •
h. Intended use and occupancy Sl ayC�G FAroN i[ y (z 5 r t7�Ai cc
�lofc q-sB..ict
3 Nature of work(check which applicable):New Building Addition Pd{€ration
Repair Removal Demolition Other Work
(Description)
14. Estimated Cost Fee
(To be paid on filing this application)
ii 5, if dwelling,number of dwelling units MIA Number of dwelling units on each floor
If garage, number of cars 9J IA
6.' If business, commercial or mixed occupancy, specify nature and extent of each type of use. N 1A
4
7. Dimensions of existing structures, if any: Front'^ Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions:-Front Rear
Depth Height Number,of Stories
4
S. Dimensions of entire new construction: Front Rear Qe� ;
Height Number of Stories
9. Size of lot:Front—_15—Rear 7 7 .88 Depth
10. Date of Purchase 9 1-7 5 Name of Former Owner Gulf YiIOAJ uZ�7 �RevcA LD/
6
11. Zone or use district in which premises are situated
12..Does proposed construction violate any zoning law, ordinance or regulation?YES_NO
13.Will lot be re-graded?YES NO }C Will excess Afill be removed:from premises? YES NO�
& 14.Names of Owner of premises B 2a0,P-A 1 ,°S i Address Phone No.
r Name of Architect Address Phone No
Name of Contractor Address Phone,No.
kk` 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 BE REQUIRED.
b.Is this property within 300 feet of a tidal wetland? * YES NO _
i *IF-YES,D.E.C.PERMITS MAY BE REQUIRED.
16. Provide survey,to scale,with accurate foundation pian and distances to property lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographicaldata on survey.
u
II. STATE OF NEW YORK)
SS:
COUNTY OF Qg5)
t
w S i_o rA F= AN co rs being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
' (S)He is the " L ye:cuTO2 of-- or PR[a2 CkC1,v0-Z_,5
(Contractor;Agent,Corporate Officer, etc.)
I
p 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 maturer set forth in the application filed therewith.
Sworn to before me this,
sr dayof eerL 2003—
Notary rwlic Signature of Applicant
DONAL O'BUCK.LEY
Notary Public,state of New York
No.020BS02333B
Qualified in Queens County
+commission Expires April 19.2007 �.
C5 P�Z
I NOT BUI^ N4 PA ENT 11
765.1802'9A FOR THE
FOLLOWING INSP NS-
'I.
S :'
'I. FOUNDATION WO RE UIRED ,
a,
FOR POURED ONC
2. ROUGH • AMING, P BINt#
4 ;INSULA N
4. FINAL CONSTRUCTI UST
BE COMPLETE FOR C.OQ 3
ALL CONSTRUCTION SHALL
THE REQUIREMENTS OF THE MY.,
STATE CONSTRUCTION A ENE GVt
ARS YN 801 "S CODES, NOT RESPONSIBLE OR
C
AA SAR BONIS DESIGN OR CONST C
o� }
Morn' SMME
+ ✓� — - �'
7.
P
_ l
qo EENS
�.
WOOD EoGINO•,y'1
FWSO vwN 4
CoNc. MON. O.L. N/5coti- - "
C- LA oop
w000
C) __-_.�� .
}* eoNc wy,L - nsawu oRW*1 -
{{J ), d
;i, li Y C.ay4E e"ONC.
�o ° UNGER NC. MRON 50.2/ jo}
ao' A of
11
i •titi a / Y � �RHf'a wIRes - O
�o�.l- / µGAI} gyp, �'� �.A,.. ��"'� •^.a � "''re
m N
r t as n; ..-• i�4'�' "•.. .;.
,
n '
_ saNt,5.,1m , , aEi
Y.
- H 1
•� ■1�����fII1111Y1
r w��p�Y►rmnun�ii iL-'��
. Y yob flnUur,�Y 1'
0MEAR;-9:111!
It
BIN
ff
r
l
O
I
/ � 100,
m
ob A
- � -