HomeMy WebLinkAbout30239-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICP_TE OF OCCUPANCY
No: Z-30270 Date- 06/28/04
THIS CERTIFIES that the building ADDITION
Location of Property: 380 DEER DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 114 Block 10 Lot 3
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 13, 2004 pursuant to which
Building Permit No_ 30239-Z dated APRIL 14, 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.
The certificate is issued to DANIEL G WALOSKI & ANO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ N/A
PLUMBERS CERTIFICATION DATED - N/A
t ri d Si.dnature
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)
PERMIT NO. 30239 Z Date APRIL 14, 2004
Permission is hereby granted to:
D & L O 'CONNOR
PO BOX 323
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR (BUILT PRIOR TO 2003)
at premises located at 380 DEER DR MATTITUCK
County Tax Map No. 473889 Section 114 Block 0010 Lot No_ 003
pursuant to application dated APRIL 13 , 2004 and approved by Lhe
Building Inspector to expire on OCTOBER 14, 2005 .
Fee $ 300 . 00
/ Authorized Signature
ORIGINAL
Rev_ 5/8/02
Form No-6
TOWN OF SOUTHOLD --
___._
BUILDING DEPARTMENT
TOWN ILkLL i -
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY =s-�
This application must be filled in by typewriter or ink and submitted to the Building Department wit t tlowing:
:i 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, iudustriat building, multiple residences and simile- buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
5. Sub mi't Planning Boa_rdApprcval 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 propeity showing all propertylures, streets,building and unusual natural or topugraphis
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.f,10. Alterations to dwelling$25.00,
Swimming pool$25.00, Accessory building$25.00,Additions to accessory building S25-00,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
r
Date. — `
New Construction: Old or Pre-existing Building:�[ S/�(check one)
Location of Property: �c e � f q
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section I Block Lot 003
Subditiision Filed Map. Lot:
Permit No. %t Z Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planting Board Approval:
Request for- Temporary Certificate Final Certificate: (chick one)
Fee Submitted: $
pplicant Signature
2-0
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. DATE: .-Feb. 25, 2.004
ISSUED TO .. DENNIS &.....LINDA OICONNOR ................................
Aut4orization
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of the
State of New York 1952; and the Southold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS-,•.', and in accordance with the
Resolution of The Board adopted at a meeting-held an ....
2004 and in consideration of the sum of $, 19Q.,.H ... paid by
en
Dnis Lidan
....... ............... ... .... .........Q'.Connor .......... .. .................................. ...............
of .............Matt'ituck ...... . N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
Wetland Permit for the c'xistin., deck, ar depicted on the
survey prepared by John C. Ehlers dated 12/22103.
all in accordance with the detailed specifications as presented in
the originating application.
IN WITNESS WHEREOF. The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and These presents to
be subscribed by a majority of the said Board as of this data.
41,
Artie Foster (absent)
Trustees
r.
a0® _ TOWN OF SOUTH®L® PROPERTY RECORD CAR®
OWNER STREET a:r ", VILLAGE DIST. SUB. LOT /Z
1 � IlahhoJ /cL7i LJ 'r;,p, ? 1 JE rtFORMER pWNER N ACR
S W TYPE OF BUILDING
RES. O SEAS. VL. FARM OMM. CB. MISC. Mkt, Value
LAND IMP. TOTAL DATE REMARKS
M044glk We Oo W. f ai+/R, F(v IJ1tv 3 !l
/GG '��11�� r` 70c'? / ..,? e" •�. /,) /..� '✓/ ,7' �e7l.R ,"'� '� B�S" iso.! Nn^ �'.,, � W. �C �M?.':'• ra ,,,
�7 P(] �i/UCd '/ Sic ✓ "� 7 �' o-°'"/��/ � �i�C"2� '��/ i/e1,� .F2/v,r:%�o�i 1u � / [F%3 j'
1 f�y
I^, 1-°t e7..~/`'} V».)(i V2..P'1 PoLa u 4 �k-irx-,a I'°if:,�'. : ��]
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD 9 ? f /
House Plot DEPTH �0
BULKHEAD
Total �.• DOCK
4 �? LAS e
� t -
4.k tit„
; �i<• COLOR
wo
t r
TRIM _ Yl YI
04J A 11111r.f�n -R.h. -MI Wh+dM1`fpS•4u�4u.:.+--� '2'
Bldg. ! 16 � C� ��.-, Foundation6 Bath Dinette
pay q/ —
'Extension
pn 8' & r !ts S� 299- Basement rid Z� Floors 3 K.
Extension Ext. Walls w o rh r o
AuInteriorFinish
Extension Fire Place Heat DR.
Type Roof (S d Je Rooms 1st Floor BR.
PRecreation Room Rooms 2nd Floor FIN. B.
Porch Dormer 1C2 a V FU
Breezeway Driveway
Garage $ dam.
O. B.
Total --- — —
BUIL-T IT RLEAE -HE C-2-K-L-L--Q
Applicant/ r Dale.
Owners Naive: Reviewed: / e�
ArchitecU, Date
En inee f Iel ry/tea,
g rte, � � __ Submitted:
SCTM H:
t � •
Districc 1000 Seuiolr. lI'� block: Lai: `3
Project 1 Subdivision -
. Location: 3F- u. —;— Name_ .
Single k separate Required
certification: (Yes t N.1 _
Req. Iteq. '/7p
%ovine Dislriol- -`,i� Ilnf sizeii E-ty Aauat: 7 i —1 [w cuecrage . I'ropuseJ Gp�,h^,
Req. j Req. t % If Req [
(frons Yard Proposed. J [Side Yard Pmpased: _-[ [Rear Yard Jz— Proposed-
Project Description: _N� r
AGENCY E� RMITS Permit .
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees iOJ s/
`-Lown Zoning Board approval:
Town Planning Board approval; _
Flood Plane Elevation???
r �ral
Flood Zone: Z,
Notes
U '
f ,
s gOFFO(,�
Albert J.Krupski, President oho CD Town- Hall
.Tames King, Viee-President Gy 53095 Route 25
Artie Foster o '�
P.O.Box 1179
Ken Poliwoda y = Southold, New York 11971-0959
Peggy_1 Dickerson Telephone(631) 765-1892
Fax(631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
February 25, 2004
Mr. & Mrs. Dennis O'Connor
P.O. Box 4561
Mooresville, NC 28117
RE: 380 DEER DR., MATTITUCK
SCTM#114-10-3
Dear Mr. & Mrs. O'Connor:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, February 25, 2004 regarding the above matter:
WHEREAS, DENNIS & LINDA O'CONNOR applied to the Southold Town Trustees for
a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland
Ordinance of the Town of Southold, application dated January 14, 2004, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory
Council for their findings and recommendations, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on February 25, 2004, at which time all interested persons were given an
opportunity to be heard, and,
WHEREAS, the Board members have personally viewed and are familiar with the
premises in question and the surrounding area, and,.
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 97 of the
Southold Town Code,
I
z
WHEREAS, the Board has determined that the project as proposed will not affect the
health, safety and general welfare of the people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of DENNIS & LINDA
O'CONNOR for the existing deck.
Permit to construct and complete project will expire two years from the date the permit
is signed. Fees must be paid, if applicable, and permit issued within six months of the
date of this notification.
Inspections are required at a fee of$5.00 per inspection. (See attached schedule.)
Fees- None
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/Ims
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. DATE: Feb. 215, 2004
DENNIS & LINDA 01CONNOR
ISSUEDTO .................... ..................... .......... .................. .......................
Autil ori 7-ati Litt
Pursuant to the provisions of Chapter 615 of the Laws of
he Laws of the the State of New York, 1893; and Chapter 404 of t
State of New York 1952; and the Southold Town Ordinance en-
r
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;'.'. and in accordance with the
Resolution of The Board adopted at a meeting held on
2004 and in consideration of the sum of $ 100..QQ...... paid by
........... .........
Dennis & Linda OTCoTinnr.. ...........
............ . ... ..............
of . . Mattituck ............. ....... N. Y. and subject to the
Terms _ and 'Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
Wetland Permit for the existing deck, as depicted on the
survey prepared by John G. Ehlers dated 12/22103.
all in accordance with the detailed specifications as presented in src
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees hosre-
by causes its Corporate Sea[ to be affixed, and these presents to
be subscribed by a majority of the said Board as of this date.
ov t-,—
Artie Foster (absent)
Trwlees
TERMS and CONDITIONS
the Permittee Dennis & Linda O'Connor
;residing-ai 300 Deer Dr. , Mattituck N. Y, as
` part of the consideration ,for the issuance of the Permit does understated and prescabe to the fol-
lowing.,
4 ) t. That the said Board of Trustees and the Town of Southold are released from any and l
a9l;damages, or claims for damages, of suits arising.directly-or indirectly as axan* of a�-oiler-
F g
#aeon:performed pursuant to this permit and .the said Permittee,will, at his.or her own"ecpeose,
rtF "
defend saay and all such suits initiated by dilrd- parries, and the said Permittee ttcsames full°liability
S 4�ith respect therein, to the complete exclusion of:dee$card of Trustees of the Town of Southold" - -
66 L
F[ I- That That this Permit is valid for a period of Z} mos. which is masideted to be the
estimated time required to complete the work involved,:but should circumstances warran5 request
. F
for as leeneusiou may be made to the Board at a later date. F Y
}
$ n_ __- 3. f That this Permit should be retained indefinitely, or as long as the said Permittee wishes f' a r
�aibrain the structure or project involved, to provide evidence to anyone concerned that auth
`drn:anon was originally obtained
1:4.
1 That the work involved will be subject to the inspection and approval of the Board or #
}i eats, and noacompliance with the provisions of the originating application, may be wise for
-V;J of this Permit by rewfution of the said Board.
7{ That there will be no unreasonable interference with navigation as a result of the work
F.he ' rized. •e -
Ii That these shall be no interference with the right of the public to pass and repass along t
! ch between high and low water marks.
t That if furore operations of the Tows of Southold require dee removal and/o[ altet'atioas
r eIlocerion[of the work herein authorized, or if, in the opinion of-the Board of Trustees, the
rause unreasonable obstnrmon to free navigation, the said Permi.ree will be requ aed,
due-aodae, to remove or alter is work or project herein stated without expenses to the Tows t-
f f. old-
Thar
ld
€
s Thar the said Board-will be notified by the Permittee at she completion of the work tm&:
J That the Permittee will obtain all other permits and consents that may be required J
gl'
dual in this permit which may be subject to revoke upon failare to obtain same. r ,-
l '
- ! d p f.
L
P -
FIELD INSPECTION REPORT DATE COMMENTS
G �
FOUNDATION(1ST) -- -- � 1�
--
u
:Yfi1
FOUNDATION(2ND)
o
ROUGH FRAMING 8•
PLUIi IBING y
�3
--------- - v
7
INSULATION PER N-Y.
STATE ENERGY CODE ---- --
FINAL —. - -- _ --
ADDTITONAL COMMENTS ,7
C
N -g
---- - --- -- Z
— -- — m
z
r
_ h
---- C b
G p
[r
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---- — -- to
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III
TOWN OF SOUTHOL'?)' _ ._'^ BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPART�WNT Do you have or need the following,before applying?
TOWN HALL 1 3 2004 Board oTHealth -
SOU J:IOLD,NY 11911." , 3 sets of Building Plan _
TEL: (631) 765-1802 ; _ Planning Board approval
FAX: (631) 765-9502 _ Sun�ey
www. northfork.net/S6uthold/ PERMIT NO. 309-3%27� Check
- Septic Form
N.Y.S.D.E.C-
I'rastzzs
Examined .2010Coitaet:
Approved ` ,20 Mail to:!
Disapproved arc_
Phone:
i
Expiration - 10 ,20 DS
Building Inspector
APPLICATION FOR BUILDING PERNNIIT
Date ?0
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 shuwing 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 tnay 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.
£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 13 months front 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 Perruit 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 inspector on premises and in building for necessary inspections. /�
nn (Signature of applicant or name,if a corporation)
T� 323 Mf-CIITUCV, N,� IIg5z
(Mailing address of appliaut)
State whether applicant is owner, lessee, agent architect, engineer, general contractor, electrician, plumber or builder
®WN�R --
Name of owner of premises _ cDENNIS k)DA QCONNto'� _
(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:
3190 .OcEdz 957
House Number Street l I Handet
County Tax Map No. 1000 Section�i _Block 0 _Lot O C)3
Subdivision DE-El Ptah-K, Filed Map No. 37-o t{ Lot_7_
(Name) — —
j --
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S I ^IG L%t- u,9M I c f Owe It l d
b. Intended use and occupancy ��
3. Nature of work(check which applicable): New Building Addition Alteration ✓
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancv. specify nature and extent of each type of use.
i. Dimensions of existin.a structures, if anv: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11_ Zone or use district in which premises are situated t
12. Does proposed construction-violate any zoning law, ordinance or regulation? YES NO
e
13. Will lot be re-graded? YES__NO(Will excess fill be removed from premises'? YES NO—)( �r3,rr�
14. Nantes of Owner of premises N'5�Liam roar'zAddress 38:�D&4z WX Phone No.
Name of Architect _Address Phone No—
Name
oNacne of Contractor Address 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 sur ey, to scale, with accurate foundation plan and distances to property lines.
1?. 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
7p ) �.
�`I' "Ice— 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 hue 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 Lu before me this P
day of 20 G
Notary Public Signature of Applicant
LNUAJ.t ^r.` 7
Noter°d sS< to 6$:3_p;Park
IRYEY O LOT 17
P OF D P. PARK 7�roroe
D JULY 25, 1960 FILE No. 5204 -- 3 2T4 N
ATE- MATTIVIOK -
M-. SOLU
=FOLK GO , NY -
YED 12-22-03
OLK GOUNTY TAX #
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AREA - 20,131 sf or 0.48 acres JOIIN C. EHLERS LAND SURVEYOR
6 EAST NI UN STREET N.Y.S.LIC.NO.50202
PHIL SGALE I"= 30 RIVERHEAD,N.Y. 11901
369-8288 Fax 369-5287 RBF.MHp serveMPROM03-318.pr°
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COMPLY WITHALL CODES OF APPRO ED AS NOTED
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NEWYORK STATF e rn',r N CODEI "
iDATE: B.P.p
AS REOU D"s C ,
FEE: 7 _ BY a
NOTIFY BUILDING DEPARTMENT AT Z . z
- ,qq0 q' 765.1802 SAM TO 4 PM FOR THE J W
FOLLOWING INSPE IONS: q� a r qa
---.DT0VVNTm,6 LE5 1, FOUNDATION - (T !0 REQUIRED ❑ u�i o ❑
NA,.DEC FOR POURED COt,�CRETE
j EXISTING HOUSE 2.3. ROUGH -INSULATION
a PLUMBING
a _ - � d-� RUCTION MUST C)
4 FIE COMPLETE CONSTRUCTIONLU
______________ _ __ REOUIREMENT�TIJ T�f C(L MEET THE LU r
_- ----------------------------- -_ _______- __________r_____ T R 4Ei LTTE rd SHALDESOFNEW
{,� 1��Y �T� OR C.O.
PLOOYI ZO11 L'
COMPL 'NITH CHA E Y' RK STATE NOT R_SPONSIBLE FOR = Z
FLOOD ut,MAGE PREVENTION DESIGN OR CONSTRUCTION ERRORS. U1 Q Y
2xe LEDGER SOUTHO LD TOWN CODE. Y wU
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OCCUPANCY OR °z W H_
i A'_LCONSTRUCTION SHALLUSE 13 UNLAWFUL o
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C DES OF NEW YORK STATE. OF OCCUPANCY
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