HomeMy WebLinkAbout29725-ZFORM NO. 4
TOWN OF SOUTROLD
BUILDIAK~ DEPARTMENT
Office of the Building Inspector
Town Hall
Souskold, N.Y.
CERTIFICATE OF OCCUPkNCY
No: Z-30311
THIS C~RTIFIES t~at the building
ALTERATION
Location of Property: 750 KNOLLW00D LA
(ROUSE NO.) (STREET)
County Ta~ Map No. 473889 Section 107 Block 1
subdivision
Filed Map No. -- Lot No. --
Date: 07/27/04
~WfTITUCK
(~AMLET)
Lot 15
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 4, 2003 pursuant to which
Building Permit No. 29725 Z dated SEPTEMBER 10, 2003
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancs, for which this certificate is issued
is "AS BUILT" ALTERATION OF G~3-~.GE TO LIVING SPACE AS APPLIED FOR.
CONSTRUCTION CERTIFIED BY ~MARK K SCHWARTZ, AIA.
· ~ne certificate is issued to SAi~DP~A BER/~_AN
of the aforesaid building.
(0WI~ER)
SUFFOLK COUNTer DEPARTMENT OF ~%LTH kPPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
g~'ature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL PULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 29725 Z
Date SEPTEMBER 10, 2003
Permission is hereby granted to:
for
AS BUILT ALTERATION
ELIZABETH ROSS
PO BOX 652
MATTITUCK,NY 11952
(GAP~AGE CONVERSION TO LIVING SPACE) AS APPLIED
at premises located at
750 KNOLLWOOD LA
MATTITUCK
County Tax Map No. 473889 Section 107 Block 0001
Lot No. 015
pursuant to application dated SEPTEMBER 4, 2003 and approved by the
Building Inspector to expire on ~ARCH
Fee $ 300.00
10, 2005.
× /./ //
Autho~i zed Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR.CERTIFICATE OF OCCUPANCY
This application must he filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of,property with accurate location of ail 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 plumbar certifying that the solder used in system contains
less tkan 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
a~d i~staltations, a certificate of Code Compliance from architect or engineer
responsible for .the building.
6. Submit Plann~nglBoard ApprOval of completed site plan requirements.
For ex~sting buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-existing" lan~ uses:
1. Accurate survey of property showing all property lines, streets, building amd
unusual natural or topographic features.
-2. A properly eomp:leted application and a 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. Certificateof Occupancy - New dwelling $25.00, Additions to dwe].ling $25.00,
Alterationsl to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses .$50.00.
2. Certificate-of Ocdupancy on Pre-existing Buildinm - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary ~rtificate of Occupancy - Residential $15.00, Commercial $15.00
Date ......................
New Construction........... Old Or Pre-existing Building..~...............f°r "as built" garaRe_ conversion
750 Knollwood~n~ to l~vin~ space.
Location of Property ................................................ ~i~c~ ..............
£
~ouse No. · Street Hamlet
Onwer or Owners of Property Elizabeth ~oss
County Tax M~p No 1000, Section.~P~ .......... Block .... ~ ........... Lot..~ ..................
Subdivision .................................... Filed Map ............ Lot ......................
Permit Ro ................ Date Of Permit ................ ~pplicant .............................
Realth Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificmte .... ....... Final Certicate..X. ..... for "as~. built" garage
~ converszon to l~iving space.
F.ee Submitted: $,.2.5 ,. p .0 ........................
'~ ~ -, ~ ........ ~-~ ~' ~!%~'~ i ...................
(,~ ~ [ ~ Abi~f~. z v Wickham, Agent
~~ -- / ~PL~CA~
"* ' :';z::- 4~'!Ma-~lt-K' Schwartz, AIA -Architect, PLLC
Pho~ (~1) 734- 4~-~
Fa~ ((~31) 7'34 - 4185
~qouthold_Town Building Department
Main Road
Southold, New York 11971
ge~
l~iT~beth Ross to Sandra Bu~man House
Certificate of Oc~pancy Application
750 Knollwood Lane
Mattituck, New York
T¢ whom this may concern:
I have ~-inspected the garage alteration at the aforementioned address. The windows
have been hinged as awnings to create the clear openings m~tuired and smoke detectors
have been installed in both bedrooms. To the best of my knowledge, the garage
alteration areas now meet or exceed the New York State and local code requirements in
place when the work was completed.
Please call this office if you have any questions or require additional information.
Very truly yours,
Mark ~hw~
UNDERWRITERS CERTIFICATe'
REQUIRED
APPROVEDAS NOTED
DATE: ~!q l~'
B.p. # ~ / ~- ~ ~:~
NOTIFY BUILDtNG 9EPARTME~ ~T
7~-1~ a~ TO 4PM
F~LOWI~ I~ECT~S:
1. ~NOATDN - ~0
~R ~EB CONCRETE
2. RO~H - FRAMING & ~B~
3. ~ON
4. F~AL -:CONSTRUC~~'~
BE COMP~TE FOR C.O.
~ CONSTRU~DN 'SH~ ME~ ~E
R~uiR~E~TS OF THE ~
~RK sTAT~: ~T
2220
(
Original
Dwelling
750 Knollwood
Mattituck, NY
Conversion of garage to living space
8O68
2520
br
m cc;~;~v con~/ioas ~at we ~csi~u~ or ~hat we
relxese~t in compli~c¢ wi~ applic~ole ~cM~al
or ~ng~n~ring stands' or gove~ent c~s.
Ap~cafion of ~e ~cMr~t's s~ is mmn~ to
indicate ~ .s is a~;~ ~e cu~nt
as-built con~fions.
D~
336{} c
4,~
br % c~368'
14'3 [
31036
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING
[ ] ROUGH PLBG.
[ ] I~~ATION
[v~] FINAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
.: I
FOUI~.a_TION (iST). ~:
FO~rD~TION (21~m) ~'~
'ROUG~ ~'G& ~ q
ST_~ ~ CODE
.
~D~ON.~ CO~TS
......
(Nare ar~l title of COrl~tal:e oEficer)
Ikfilders I.icer~e Bo.
Pltsd~ers I.ic~nse
0223
O~r ~'S Li~ ~ ......
750
1~ ~r
~ivisi~. ................. .
(~).
a. ~isci~ ~ ~ ~ '~..
'1
· FORM HO. I · 3 S
TOWN r.F 80OTI.IOI.D SUB
TOgN HALL
SOUTIIOLD, H.Y. I 1971
TEL: 765-1802
APPLICATION FOR IIUILI)XH¢ PEICHIT
INS'I'RUDTIONS
~ale. F~ ~{~ ~o ~le.
:i~, the ~ildi~ %ns~ccor ~{il is~ a ~i
~ ~'ind~la ar In ~rt [or any ~
~TS OF PLANS ......... ' ......
~E¥ .........................
~IC FOP, It ...................
)TIFYz Abigail A. Wickham
298-8353
Mattituck, NY 11952
Sept. 4, 2003
ldinll P~m|{: to the applicant, Sud~
~ate4er tmtil e CertifiCate of
Bulldin& ~parla~nt for tim tssuar~_e of a I~ ildir~ Pemlt ~rm~t to tl~
.ildi~, ~ict~s or alcerati~s, or f~ ~,i~val or ~lirion, ~ hereh,
,lictor, or ~, {f a ~ratlm)
drees of ~licmt)
~,a c~ ~11 or lmtest
-}lark, fichwartz, Registered Arch tec~
~rk ~ill ~ ~ ................
Mattituck
Hamlet
15
Knollwood Lane
107 , , . Block ..,1
...... Fltefl ~ I,~ ........
pr~rM~es and intecded ~ ar4 ~ccvpar~-y c
single family dwelling
.~i=. a~a..f..~4, l%L .d..~.eil%.~.g. ..............
Coal: ........ · .... ....
=able)= ~ llqildlng .......... t~dh;lon
........ I~ml ll;io~ ............ Ocher ~t
*'conversion tp ~ving s~
(~o ]~ ~Jd tm ~llJ
detached arage
~ any= ~C ...... 6~-60~ ~a~
~dmr o~ Stories one
'
........ ~ar 167.33'
.................... P~p~I~
h ~l~e of u~e.. ,.n./.a. ...............
:?.o.' ...... r~pm... 3.~... b.q'. .......
.... i Depl:h ..............
100' & 82'
I(I.
II.
12.
13.
15.
~x~ or u~e. di~crict !n,~hzch pr~iseal, an~ situated
~. prowl ~m~xm vl~la~= any ~l~ 1~, o~l~e o~ ~lagl~= .......................
Will. lot lm regr~ ........... ~. ....... Will mas fill ~ r~ Nm I 'm~*: ~
., . ~._~ _.. EliZabeth Ross --, 750 Knoll~ aod Lane, -- --298-8353
~ of A~,i~ ~[~k.S~va:'tz ................... ~..~. Ha~a' ~rs Ro~d. ~ ~73.4-4185
..... c.t gt6~&; '~' i'f9~ ........
~ of C~[r~tor....... .... ...,..,.,.,..,,.....,.,. ~ress .............................. ~ ~ ...........
~s this pm~r~ w~tldn ~ f~t mga [1~l ~Cl~? * ~ .......... ~ ..~ .....
~[,~'[' DIAGRAM
, ~[ld~s, ~[tmr ~Jst~ or p~, ~ ~ate all ~E-~
PLEASE SEE PLANS PREPAR]
C[I1NiY ~I~ . .S[3?~QLK ............
u,~ . ~...'. ...... ". ........
the ~)[k
........ .........
, No. OtMC,
Ouallfle~ ~n Su
BY MARK SCHWARTZ (ENCLOSED).
................... Ix~hq~ d.ly s~ont, delx)~ee atxl says Omi: he
JthocI~ Co ~rfonn ar I,~ l~rf=n~ the ~[d ~rk a~J ~o .rake ami file chis
,r . ~.- . .2.0. 0. .%
:e of New ~1[
851459
folk County _
;/tug, 18, ~oo~ ·