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HomeMy WebLinkAbout28973-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30177 Date: 05/05/04 THIS CERTIFIES that the building ADDITION/ALTERATIONS Location of Property: 1015 FACTORY AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 2 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 4, 2002 pursuant to which Building Permit No. 28973-Z dated DECEMBER 4, 2002 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. The certificate is issued to MARGARET T BRADLEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2098H 04/28/04 PLUMBERS CERTIFICATION DATED N/A c c Aut zed ignat re 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. 28973 Z Date DECEMBER 4 , 2002 Permission is hereby granted to: MARGARET T BRADLEY 1015 FACTORY AVENUE MATTITUCK,NY 11952 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1015 FACTORY AVE MATTITUCK County Tax Map No. 473889 Section 122 Block 0002 Lot No. 021 pursuant to application dated NOVEMBER 4 , 2002 and approved by the Building Inspector to expire on JUNE 4 , 2004 . Fee $ 150 . 00 Au orized ORIGINAL Rev. 5/8/02 t - Form No.6 TOWN OF SOUTHOLD Y `a n 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. 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, Alterptions 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. '51-3104 New Construction: Old or Pre-existing Building: (check one) Location of Property: D t T--a.Jo M Ae- 4 House No. Street Hamlet Owner or Owners of Property: rt Q V-q a-ec"� /�i-4j Suffolk County Tax Map No 1000, Section ! a a Block 000 ;- Lot b a / Subdivision Filed Map. Lot: Permit No. a g9?3 Date of Permit. i a I y I�� Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ a 5.60 W ) n Applicant Signature C0 -,2" I7� Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street Center Moriches,New York 11934 • Tel: 631-878-3500 •Fax: 631-878-3764 Application: 2098-H Date: 4/28/04 Issued to: Kolbenheyer Address:. 1015 Factory Ave Village: Mattituck Introduced By: H/O Lic#: N/A was examined and approved up to the above date and was in compliance with the NEC Arc 1st Floor R dderiial D Pod Det Garage BwwBtEl 2nd floor Comrerdd Hot Ttb Addition Switches Receptacles Fixtures G.F.I. Range Hood Whirlpool 3 10 4 Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon Range/Amps Monoxide Furnace Oil Gas Heat Zones Smoke Bell Detectors Transformers 1 Meter Amps Phase Motors 1 200A OH 1 Other Equipment: 1-60A Sub Panel Service Upgrade & 2nd Floor Dormer ut,Res This certificate must not be altered in any maner 4 2002 ENERGY CODE CALCULATIONS CTER 5 SECTION 501 Detached One and Two Family-----::-`-� -Design Criteria 5750 Degree Days (For Non-Electric Heat) Zone 11B For:_ I('o/6t b �eyer �ah� it.. � Pe �G ? r: y D/S- F6C/sr Avt of k Dated: 12 /6 e SUBSYSTEM AREA DESIGN CODE DESIGN CODE CCU V> rte„ UA UA Exterior Walls S 7 . 8 0.14 Ceiling Roof 2. 33 O 0.031 Floor Over Unheated Space 0,05 Heated Slab On Grade 6.5 Unheated Slab On Grade 4.5 Basement Wall 0.1 _ Crawl Space Wall 0.06 NOTES: L .3 3 .8 &15', j Z COnstiuction 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 �Nrc,E To the best of my knowledge, belief, &professional'judgement, `- x these plans are in compliance ��T 032254-t with the code. °10, OFESSM1a !/ Z f 0 .. ■■■■■■■■■■■■■■MEN■■ oar. ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■� ■■■■■■■■N■■■■mom■■■ ■■■■■■EM MENN ■■■■■■ . .t .� ■■■■■■■��®ter ■■■■■ ■■■■■■:■� :■■o■■■■■ ■s■■■■■SNE ■■■■■■ ■■■■■■■■■■■ ■■■■■■ ■■■9 ■■■n■■■■ Mao, Floors Interior Finish Fl— Pf-ce •. Rooms Ist Floor o TOWN OF SOUTHOLD OOOPERTY RECORD CARD A OWNER STREET !v 1�5 VILLAGE DISTRICT SUB. LOT 4 60vo 7Z� FORN(ER OWNER N E ACREAGE ti vo S , . W ,7 soN 7aS TYPE OF BUILDING ZES - �0 SEAS.. VL. FARM COMM. IND. CB. I MISC. LAND . IMP. TOTAL DATE REMARKS /7 oG / L j.cJ 44/ 74, v✓ !< l iP o v 12o7S l3C A. ��" '? `p`{'� /- ;;f_ IapJi`04/ 2f.. 966 6 AGE S, / BUILDING COND I NEW NORMAL BELOW ABOVE f �. e Acre lueef� --/ Fillable 1 Fillable 2 Fillable, 3 c b l I ���'� ! ��b _ O s 3 /Vcodland ;wampfand 3rush.land House Plot Fotal Vd %a ENERGY CODE CALCULATIONS 4 L'02 C iAPTER 5 SECTION 501 Detached One and Two Family- Design Criteria 5750 Degree Days (For Non-Electric Heat) Zone 111 For: Ko�6t b �eycr Per: ?ehA) ----- t� 4 k Dated: . 2 /6 e Z e. /0% r SUBSYSTEM AREA DESIGN CODE DESIGN CODE ��» «U„ UA UA Exterior Walls 2.3r T 0.14 Ceiling RoofZ 3 3 , O 0.031 . (e�' 7. z 2 Floor Over Unheated Space 0.05 Heated Slab On Grade 6.5 Unheated Slab On Grade 4.5 Basement Wall 0.1 _ Crawl Space Wall 0.06 NOTES: L 3 3 , 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 . oENfW),9 N 'f' Q To the best of my knowledge, �. belief, &professional'judgement, e theseplans are in compliance �� - �O 032254-1 with the code. A?OFEss10kP� - �uc�'vE���o F•-o� I r u TowN UF-- Sai-rk•tot-o, N.4'. ' � fsn.a a�h tirtaY � alortcj litre r Y once 1.8 G� Z _ &heal s -• C) IL f\) III I - fort. �4 _ N fJ a-i N. ' Z15,ONTO f 5 In /I 4 ,1r Ar►�a O. X71 act /� {t7 =' filt�trtJtrlBr'7't' jil j %I l ns k- Ccxitrfj-rcxx fvlap 1 3r�rrt�rfiorr: Ti+I& No.&F--e--Or Unauthorized•nation a @Mtk n 1 :JG rYXrt'�L�cV 'li7 '�Ic`� to tnn survey is•Wobtkn of Section 7209 of the New Ywk SIM �hrcaga Ti-f�P In SrJr't�crrc� ::�rri�x7'�`/ Education Law. a rtd -k� ffre D itrre :�a�'►r r N h rn r is, comes or thfe Mvgr tep trot f�fhrO _ me sand sunM•r•Nibd ad•r { emtlussed e••1 elt•M ttstMrt�id�rrtM , 1 ir,be a valid vw 0". i Ir'l7C lam'i G lG V,4N TIJ ,"L, +,w-rantees india•t•d h~Mfr f" w to the 11M1d11N#•OMM41111119P1I141111119PNI1 d1N cnandandah•bgMn :i,moenY.Oovem � •1:,;institution Hated hWM M1d 4 L.iGerrS�or Lafrc! Ur-v�1ori s.sttnoasofOw6wdbVbe • Gtr r�Of"F lVCW •YOrk_ l varteet•r•tta -1 'IN ::sdcutloM a•ttb•pusrti ! r BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: Jl_/__�/02 APPLICANT: DATE SUBMITTED: 11 /_q_/02 SCTM# DISTRICT: 1,000, SECTION: 122 , BLOCK: _2- LOT: STREET ADDRESS: 1015 lv_ A119. CITY: SUBDIVISION: N .4 PROJECT DESCRIPTION: Awrrza S +x1y A-7m4vara o�'`�� /�l�• ESTIMATED PROJECT COST:/gam ARCHITEC �IN ��y� c c FAST TRACK? wed SINGLE & SEPARATE CERTIFICATION-REQUIRED? Ky NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTSFROMJAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83 /C ZONING DISTRICT: �,y� CONFORMING? C/ REQ. LOT SIZE: & 066 ACT. LOT SIZE:2 REQ. LOT COV. ACT. LOT COV. REQ. FRONT y� PROP. FRONT ✓r"REQ SIDE ACT. SIDE REQ. REAR �p PROP. REAR REQ. EIGHT PROP. HEIGHT WATER FRONT? A/0 ESCRIPTION: PANEL #: FLOOD ZONE: , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH : YES o O, BED #): DTE:_/ /_ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y NEW YORK STATE DEC: rxE- 9/1/75 YES SOUTHOLD TOWN TRUSTEES: YES TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES NYS ENERGY: YES OR NO EGRESS (18 H min.? 4 sq total) T(SQ. FT. x 4%) --�IGHT(SQ. FT. x 8%)__�_ BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z_ HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: 1 Iq SF SECOND FLOOR: Z� SF OTHER: SF INIT OTHER TOTAL TOTAL: t 3 nSF FEE 7a) � 1. ( SF)- _SF)= SFX$ _$ +$ +$ 2. ( SF)-( SF)= SFX$ =$ +$ +$ =$ BUILDING DEPT. INSPECTION [ j FOUATIO i$T [ ] ROUGH PLB�i. ND [ ] FOU ATION 2ND [ ] INSULATION [ � RAMING [ ] FINAL J FIREPLAC HIMNEY REMARKS: " zzl��e ---mww- OF DATE �S � IN8PECT0 BUILDING DEPT. INSPECTION FOUNDATION 1STISTRO PLsG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY ` REMARKS: �//S�✓�/�-l7 J.Z✓ c-I�/C �S Cr7�r-tel .• DATE INSPECTOR . 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: -74 (1,-e DATE ` 10(74_�` INSPECTOR 7 � -?- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ 4- FINAL IN ATION [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: c DATE �53 INSPECTOR FIELD INSPECTION REPORT DATE COIVIl"NTS b FOUNDATION(1ST) z � C FOUNDATION(2ND) ' x /. y0 O \ vo ROUGH FRAAMG& , y PLUMBING 3 - INSULATION PER N.Y. STATE ENERGY CODE ol FINAL Jprr ADDITIONAL COMIVIENNTS O m JLc � O x d TOWN OF SOUTTIQLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the followigg,befort applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 / . 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 �G Survey www. northfor .net/Southold/ PERMIT NO. l Check Septic Form N.Y.S.D.E.C. / Trustees Examined V 20 Contact: Approved ,20___q/ Mail to: 10 ('�; Fa c-6 i,4 N e Disapproved a/c—A— /c ryk&4-C 41) Ck 0"-t I\fir Phone: a 9 - 41-7 Expiration 20rl di g s ector 4 200 I APPLICATION FOR BUILDING PERMIT 4' ""! D Date I I 10 L , 20 0 a 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 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 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,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.. / /7 C (Signature of applicant or name,if a corporate n) /0 15' FQ C-40 r- f 4 y e-n Je Aa*44- , JV 'i 4sa- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder &Joey - Name of owner of premises �'B radl.0-4 a r qct r.e T. (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- / 615- one:/ 61Jr F-a. "--(oW 977Z/ House Number Street Hamlet County Tax Map No. 1000 Section Block Lot o Subdivision Filed Map NO.- Lot (Name) 2. State existing-use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 5 f e b. Intended use and occupancy. Awe( 1 64 3. Nature of work(check which applicable): New Building Addition ✓ Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost , 00 O • 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front y I Rear LI 1 Depth a ' Height � ' Number of Stories . Dimensions of same structure with alterations or additions: Front Rear Ll 1 Depth 3© ' Height a r'O ' Number of Stories C 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 1 15 Rear I� -5 Depth o) 5 (v 10. Date of Purchase I I a 018 s Name of Former Owner �So n e S 11. Zone or use district in which premises are situated W S k dlenA-t a.k 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 mar•c,�re-I- �r���'� 14.Names of Owner of premiseskol6"Kgh �Lv- Addre s ion 5 Fa-Cbr,t ��- Phone No. aqg S`t 17 Name of Architect L"revice--r-j+6%1� AddrgRft"^``' `'""�`"� Phone No y, - 04 o0 Name of Contractor R�berg- me sq u era Address a 5 s v, ��a c ^'phone No. 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 * 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 ) being duly 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 performed in the manner set forth in the application filed therewith. Sworn to before me this day of Al D eA4 b 20 D a &g�_4 -, � Notary Public Signature of Applicant OF Monica Cerise NOTARY PUBLIC,State of New York No.01 CE6059403 Qualified in Suffolk County Commission Expires May 9,20 - OFFICE PROVIDE OPENINGS FOR EP:SERGENCY ESCAPE AS REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE. APP 1101 AS NOTED - DA '�2 2B.P.fa 0 l� er:L�l � , NOT BUILDING DEPARTMENT AT 7954802 9 AM TO 4 PM FOR THE o FOLLOWING INSPECTIONS: v 1. FOUNDATION • TWO REQUIRED FOR POURED CONCRETE 2. ROUGH • FRAMING t PLUMBING 8 INSULATION 4 FINAL • CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION A ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS I PROVIDE SMOKE-DETECTING _ ALARM DEVICES 7 AS TO PART.721.1 N.Y.S BUILDING CODE.CE i i UNDERVIWIRERTIFICATE 0 OCCUPANCY OR IS — E ¢ a 9 WITHOUT CERT FICAT - - -- OCCUPANCY NC o� W --- — -- — ...---- -- - ----. ------- _— ¢ x Y --- 5 O o z n 71 c� r l l� I� r I P I v " '� I Lu Q a I I I + I I f I iU I cr J Op 08225d-1 ' 9OEESSIONP 4 5 _ L O a i , IY c+. I_ I I � _ ��G'tzzah-� ry. 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