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HomeMy WebLinkAbout29072-Z FORM N0. ,4 TOWN OF SOUTHOLD . BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29986 Date: 04/22/04 THIS CERTIFIES. that the building ADDITIONS/ALTERATIONS Location of Property: 1520 DONNA DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889. Section 115 Block 15 Lot 14 h — ?; Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore p filed in this office dated DECEMBER 31, 2002 pursuant to which Building Permit No. 29072-Z dated JANUARY 6, 2003 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 ADDITIONS. & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. n p �. The certificate is issued to HENRY & LINDA KOZEN (OWNER) of the aforesaid building. f i H SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1194277 02/19/04 PLUMBERS CERTIFICATION DATED N/A .zut rIl ize Signature i 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) r PE:16gT NO'. 29072 Z Date JANUARY 6 , 2003 Permission is hereby granted to : HENRY & WF KOZEN DONNA DR MATTITUCK,NY 11952 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS & APPLIED FOR at premises located at 1520 DONNA DR MATTITUCK County Tax Map No. 473889 Section 115 Block 0015 Lot No. 014 pursuant to application dated DECEMBER 31, 2002 and approved by the it Building Inspector to expire on JULY 6, 004 .; J Fee $ 150 . 00 a Au6,horized Signature 7 f ORIGINAL Rev. 5/8/02 .I I i /"Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN BALL 765-1502 u � r APPLICATION FOR CERTIFICATE OF OCCNC /) This application must be filled in by typewriter or ink and submitted to the Buil ' glle with the folio g: �y SFrA. For new building or new use: L 1. Final survey of property with accurate location of all buildings,property lines, streets, and un I 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-CodrzComp3iancne from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing bpild1 igs(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 properlycon?pleted 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,Additions to dw lling$25.00,Alterations to dwelling$25.00, Swimming pooi!325.00,Accessory building$25.00,Additions to accessory building$25.00,Businesses $50.00. 2. Certificate of Ozceupaucy on Pre-existing Building- $100.00 3. Copy of Cerfifiicaxe of Occupancy-$.25 4. Updated Certiocate of Occupancy- $50.00 1 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 { Date. j f New Construction: Old or Pre-existing Building: _ 9o)J/ (check one) Location of_Property: A)elJ� House No. Street 'Hamlet {' Owner or Owners of Property: Ve ) 7°v" ✓l Suffolk County Tax Map No 1000, Section / / Block nz) I Lot Subdivision Filed Map. Lot: Permit No. 0 Date ofPermit.L ;f d'a/ Applicant: i Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ or- !�/ App ant Signature ��`�33 P a ti� cis �Ci ° C C CPC C.I�C.I�C.IC C�LnCCPC.I�C.IC.I�C.I�C.I�LnC.�C.ILnGnCCnC�CEPC 2 Rr@LnL3rL3r.I�C.I�C.I�C�C.�C.nC.I�CnC�LnLl7Ll�C�C II�C.I� ❑° 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 BUREAU OF ELECTRICITY c5 fj 40 FULTON STREET -- NEW YORK, NY 10038 S 5 5 _ CERTIFIES THAT 5 1 Upon the application of upon premises owned by 5 5 • SABAT ELECTRIC HENRY KOZEN 5 50 PAT LANE 1520 DONNA DR. 5 MATTITUCK, NY 11952, MATTITUCK, NY 11952 5 5 Located at 1520 DONNA DR. MATTITUCK, NY 11952 Application Number: 1194277 Certificate Number: 1194277 5 5 5 Section: Block: Lot: Building Permit: BDC: nsl 1 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: First Floor, 5 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was 5 found to be in compliance therewith on the 19th Day of February,2004. 5 Name QTY Rate Rating Circuit Type 5 5 Appliances and Accessories c Dish Washer 1 0 1.2 KW 5 S Cooking Deck 1 0 6.5 KW 5 5 Wiring and Devices 5 Receptacle 14 0 General Purpose 5 5 Switch 5 0 General Purpose 5 5 Fixture 8 0 Incandescent 5 Dimmers 6 0 5 Receptacle 2 0 GFCI � 5 5 -tS 5 5 5 5 5 5 seal 5 � 5 5 ,7 1 of I 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 5 5 : rJ�rJ�rJrJ�rJ[rJPLPLPrrJ�rJ�rJ�rJ�rlcf&,lj2 &3Prrj'C3 �r�r�r�rJ�r.PrJ5PcP�PrJ�rJ�cJ�rJ�rJ�rJ�r�rJ�r�r�rJrJr.PrJ�r1rJ�rJ�rJ�rJ�r�CJ�CJ�rJ�r�r�r.J�rJ�rJ�rJ�CJ�rJ� ❑° ENERGY CODE CALCULATIONS CHAPTER 5 SECTION 501 Detached One and Two Family Design Criteria 5750 Degree Days (For Non-Electric-Heat) Zone.l lB For: pee i52o oonbc_ 3/ "/L' s4y,f c& / Dated: Ve-^,y i 2 3 0 jAe�f`/ SUBSYSTEM AREA DESIGN CODE DESIGN CODE «U„ «U" UA UA Exterior Walls 1/LO 121.2- 0.14 20&00 230.7° r Ceiling Roof 111,34 .63 0.031 xi3. O 411�•S 2- Floor Floor Over Unheated Space f 3 o j� 0.05 -71, 80 ; 7/. RLI Heated Slab On Grade 6.5 Unheated Slab On Grade 4.5 Basement Wall 0.1 a Crawl Space Wall 0.06 NOTES: I322 .f/ 3'Y 7 ,011 Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage Building Envelope Systems to meet requirements of Section 501 The mechanical systems and equipment including: HVAC Equipment,HVAC Systems,Duct Systems,Ventilation Systems and Insulation of Piping Systems to meet requirements of Section 503 Service Water Heating Systems&Equipment to meet requirements of Section 504 Electrical&Lighting Systems&Equipment to meet requirements of Section 505 To the best of my knowledge, Y belief, &professional judgement, these plans are in compliance ,, with the code. ' - Iv 3l 0 ENERGY CODE CALCULATIONS CHAPTER 5 SECTION 501 Detached One and Two Family Design Criteria 5750 Degree Days (For Non-Electric Heat) Zone 1113 For: Weh�y oZeh Per: /5-20 MB�l f c ti Dated: 01 i 2 31 7d,14 � DESIGN CODE DESIGN CODE SUBSYSTEM AREA "U "U" UA U4 Exterior Walls 16 Z13 , a/-2-z 0.14 206003 2.3 n.7° Ceiling Roof tf3 6 03 0.031 i13- o e 1/14-S2- Floor /14.5LFloor Over Unheated Space /Y 3� 0'5' 0.05 -71, 8' 74 8 J i Heated Slab On Grade 6.5 f Unheated Slab On Grade 4.5 s a } Basement Wall 0.1 ,4 Crawl Space Wali 0.06 NOTES: 3 2 NOTES: ?g Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage { Building Envelope Systems to meet requirements of Section 501 ' The mechanical systems and equipment including: HVAC Equipment,HVAC Systems,Duct Systems,Ventilation Systems and Insulation of Piping Systems to meet requirements of Section 503 a t Service Water Heating Systems&Equipment to meet requirements of Section 504 Electrical&Lighting Systems&Equipment to meet requirements of Section 505 "of INEW To the best of my knowledge, _' { belief, &professional judgement these plans plans are in compliance v , M2254-1 with:the code. rsslo��`� Y a i t ;SIR,1 x,. 87 ­20 90i ' w 36 1 � CESSi'L}ULST� s.r. —4.2` N � p a s irW � x " 1 w � Yi_pr / E S ' e LOT- f� 7 \ t1s, X09 . x 1VELL m ORIZED ALTERATION OR ADDI ON H SURVEY 15 A VIOLATION OF 1 N 7209 OF THE,NEW YORK STA E V 76,$¢ ION LAW, f D IE OF THIS SURVEY MAP NOT BE ING 83•'20'40 wt 0 ND SURVEYOR'S INKED SEAL'OR - O SED SEAL SHALL NOT BE CON51 RED B A VALID TRUE COPY. { NTEES INDICATED HEREON SHAL RUN \ LY 16 THE 1Ef.50;d FOR VIHOMJHE SURVNI '•.\ K ii iR RARE6 AND O..HIS KHALF TO E_ LE COMPANY OVLRNMENTAL AG Y AND �\ AD NO:INSTTUiION.LISTED HEREON, ND HE m,"llES DE THE LEKDING 1 YF V NTBFS AEE NOT TRANSFERABLE « ii N:GLYAFA, OR„SUBSBOLIH'T<<,, --w...�,�;—=.. a...•+ ., nEaa+Ad1 .T?Z,�.Tlor MAP OF < PROI ERTY SCALA • 40` SURVEYED FOR El = momumENT • jRpN PIPS _ NRY S. & LINDA, kOZEN SITUATE AT ro 5UF70Lu COU WrY M ATT I TU C K F.1=DERAL SAVINGS Aj4.R 'LOA0 TOWN OF SOUTKOLD, N,V, A5ZG, 'N..`AND TO THE CI�iCACi(3 TITLE JNSU[LAi'i"CE • SURVEYEiD akz 6 ,A ql� � < T`14iJMBERS SHOWN IZEFEiLTO ".MAP Y E,",-• i »h Ef+P?NLOLE CREEK EST$." FILED IN Si1VFOLK COUNTY CLEtZWS%OFFICE LICENSED LAtiSR SOytr Y . „iuC/sP.-N£ 4256 GlirEtY4JRT,t.l,t1<1V'Y'DKK TOWN 8F SOUTHOLD PROPgRTY RECORD CAR® .L OWNER STREET _,. . ~} VILLAGE DIST. SUB. LOT FORMER OWNER N E ACR. a $ W TYPE OF BUILDING ZES. SEAS. VL, FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS lJ O Sd G Ca 4t 0 m ' a .z�Aj rS ff° 7 I1 uZ t M f a u o.a z Q s1z 6' — g&o�Ip° o x'71 tj S'yod 9 .2y AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable I Tillable 2 rillable 3 Noodland swampland FRONTAGE ON WATER 3rushland FRONTAGE ON ROAD -louse Plot DEPTH BULKHEAD Total DOCK BRIM RPM ■if ■r is orlum■��i■�■■ ■ < <, �■ ■■■ ■�■ �������■ ■ ��� dip■ ■ r■S ■■■\r ■ ■ �■ ■ Foundation :. —�® :. - .. BUILDING PEkMT EXAMINER CHECK.LIST DATE REVIEWED: i /C_/02 APPLICANT: � � I DATE SUBMITTEDi�/at/02 SCTM#DISTRICT: 1,000, SECTION: 1 _, BLOCK: 15 ; LOT: 4- STREET.ADDRESS:. CITY: SUBDIVISION: PROJECT DESCRIPTION: Q �f].�� ESTIMATED PROJECT COST: c, ARCHITEC� ]� R: 1 o f r r-L FAST TRACK? A-) SINGLE & SEPARATE CERTIFI ATION-REQUIRED? Al cJ NOTES: LOTS 4%600SF-10U 24.Lot recogn3hon.(CREATED before Jzrrie 30y 1983),UNDERSIZED LOTS FROM JAN.1997 L00-25.Mergev(A.nonconforming at any time after 7/1/8: ZONING DISTRICT: ".0 CONFORMING? Ay D REQ. LOT SIZE: W40 ACT. LOT SIZEoI 3 ( REQ. LOT COV. C- ACT. LOT COV. REQ.FRONT ro PROP. FRONT -5�,/REQ SIDE !S ACT. SIDE REQ. REAR���� P`R/OP. REAR 'REQ. HEI HT PROP, HEIGHT WATER FROMT?� /ey DESCRIPTION: PANEL #:-� FLOOD ZONE:_(� APPROVALS REQUIRED : SUFFOLK COUNTY HEALTH,(� `�T:.YES o O, (BED#):_DTE: /_/i PERMIT#:R10- TOWN SEPTIC RECEIPT: Y r r NEW YORK STATE DEC: PRE=DEC 9/1/75 YES SOUTHOLD TOWN TRUSTEES: YES Or TOWN ZONING BOARD APPROVAL:YES or aj TOWN PLAN. BOARD APPROVAL: YES o t, TOWN HISTORICAL PRE (SPLIA): YE o NYS ENERGY: OR NO : ✓/ EGRESS (18 H min.? 4 sq total) -VENT(SQ. FT. x 4%)__________LIGHT(SQ. FT.x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- HAVE PRE CO'S : Y OR BP -Z/C/o Z_ NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF f SECOND FLOOR: SF OTHER: SF INIT 'OTHER TOTAL TOTAL: //3 SF PEE FEE I. SF)- SF)= SFX$ =$ +$ +$ 2_ ( SF)- (SF)= SFX$ =$ +$ +$ _$ 0 72 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSUwl ION ] FRAMING [ PINNAL i [ ] FIREPLACE & CHIMNEY REMARKS: � L DATE /03 INSPECTOR - y M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. ] FOUNt)ATION 2ND [ 1 INSULATION [ FRAMING [ j FINAL [ ] FIREPLACE A CHIMNNEEYY REMARKS DATE [ 7 03 INSPECTOR 477 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ } ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION 1NG [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS; DATE ` �� INSPECTOR _ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO GH PLBG. l FOUNDATION 2ND [ INSULATION I FRAMING [ ] FINAL FIREPLACE A CHIMNEY REMARKS: '��r� DATE ?/4)- INSPECTOR M-1802 BUILDING DEPT. SPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ 4--F-bUNDATION 2ND [ j: INSULATION [ I FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE ' INSPECTOR- M t_liO1Y1WLl1D '+ ,41 FIELD IlVSPECZTONRtO'OHT D i FOUNDATION(1ST) 3 ' 1 j r FOUNDATION(2ND) 46 t' ROUGH FRAMING& o MUMSING 3 1 INSULATION PER N.Y. STATE ENERGY CODE N I FINAL ADDITIONAL CONwYMENTS Is t" a 'i � ivwivkv ,6uU111WL" t$U LIANOPtXMI1 „AY?LICAfIUN, (AiECKLIS BUILDING DEPARTMENT Do you have or tided the follo4ing,before applying TOWN HALL Board of Health SOUTH, OLD, NY 11971 3 sets of Building Plans TEL: 765-1802 Survey' PERMIT NO. lc::2�0 Check Septic Form N.Y.S.D.E.C. /e/ Trustees Examined 20_22 Contact,- 1� .Approved 2Q , - Mail to; Disapproved a/c -21 Phone: "uildector 9 APPLICATION FOR BUILDING PERMIT r Date 20D-*—`— 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 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 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.No building shall be occupied or used in whole or impart for any purpose what-so-ever until a Certificate of Occupan is issued by the Building Inspector. 'i 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 constructi5n of buildings, additions, or'a'lterations or for removal or demolition as herein.described.The applicant agrees to comply with all applicable laws, ordinances,building code,housing code; and regulati s, and to admit authorized inspectors on premises and in building for necessary inspections. { (Si eof a licant or name;if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect,engineer,general contractor, electrician, plumber or builder i Name of owner of premises . k!5-IJ K S, 9t 1—ZJ1)>A -Y. KO ZE-Al (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. 1. Location of land on which proposed work will be done: fSa Tjo N N ik D,-71 V House Number Street i Hamlet County Tax Map No. 1000 Section ! f 5 Block J Lot f Subdivision 17g fz Filed Map No. S6 Lot 3 (Name) State xi rng�u`se avid`occtxpari y o pzeses and intende use an/d�occupancy of proposed co tract on; a. Existiig use and occupancy �o/ It. Intended use and occupancy ji�&Ski A t` cmc Nature of work (check which applicable): New Building_ Addition Alteration Repair Removal; Demolition Other Work (Description) Estimated Cost YA caFee T (to be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars" If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if anyi Front Rear Depth i Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories Size of lot: Front Rear Depth 0. Date of Purchase Name of Former Owner 1. Zone or use district in which premises are situated 2. Does proposed construction,violate any zoning law, ordinance or regulation: 3. Will lot be re-graded NO Will excess fill be removed fm m sees: YES NO 4. Narnes of Owner of premises o-ZL N Address 4M ( N j�'4 012 Phone No. Z Name of Architect Address Phone No Name of Contractor Address Phone No. Is this property within 100 feet of a tidal wetland? *YES NO Z . • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey,to scale, with accurate foundation plan and distances to;property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE.OF NEW YORK), SS: ;OUNTY OF ) being duly swom, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, i)He is the (Contractor, Agent, Corporate Officer, etc.) I said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; tat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erforined in the manner set forth in the application filed therewith. worn to�efore me this 3 s day of 0.2cnns.:-,h9 - 20GO- NotaVjublic tgnature of Applicant Pamela J.Dunn Notary Public,State of New York Registration#01 DU6039460 Qualified In Suffolk County My Commission Expires April 3,2009 OFF1G� I I OCCUPANCY OR USE IS UNLAWFUL W178 ,MUT CERTIFICATE { iz OF OCCUPANCY 1 i APP EDASNOTED o3� I� DATE _ _,.-._. .._-•--._ _- .c,._, _. - ..:. �- � ... It i FEE -I- _ I f, I' . NodTI YBUILDING A TMENT AT DEP 765-1802 9 AM T0,4 PM FOR THE !P � . ✓� , . FOLLOWINGINSPECTIONS: 7. FOUNDATION - TWO REQUIRED j t $X!{'T`1ff'37 � � � I� �il'�•W. 669W4- FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING i' , /irymt. tar I ' 3. INSULATION 'ONSTRUCTION MUST 4- FINAL - C / - BE COMPLETE FOR C.O. J( ✓�lkl4fh7� r© � I ' ."'� . ALL CONSTRUCTION SHALL MEET E,� ig'-f, 1 THE REOUEREMFNTS OF THE; N.Y, I ( -, r" h'v app;, i STATE CONSTRUCTION & ENERGY fits. ` T1S II CODES. NOT RESPONSIBLE FOR j DESIGN OR CONSTRUCTION ERRORS '_ . . ..._ 'G UNDERWRITERS CERTIFICATE j - -� ` '-re rrl?a I; REQUIRED j- *}! m.✓ / 'n- .Kw .mss - - �I � iIk'/57/k'C t I ; I` Ij MEW Y 6 xe µ!✓EW - - Rtl - --"-"--- ' ' ails tRte�' .txc.t•,6f CN✓� 'a¢.,, ✓ I ( 1 , n ^Tio ^T 17 - 1 1 - I ' xl .�i �> ' '` � I � .�lXs � � R ' i , -� d n? ✓N5 I _ Ii ' Lpi �rav� r , r�F - tiFX'L I f � � � l+ ✓1NIf 4. I ! T. !, ,moi fret r I �E of nEW I P ( Q B FE£StD,1c. +;fAiF ✓ .!^. }Z E- ,, h'�,'^ 17fr '.:r(�!r 1