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Home My WebLink About30459-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30540 Date: 11/10/04 THIS CERTIFIES that the building ALTERATION Location of Property: 1805 GRAND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 107 Block 8 Lot 41 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 30, 2004 pursuant to which Building Permit No. 30459-Z dated JUNE 30, 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" CONVERSION OF AN EXISTING ATTACHED GARAGE TO LIVING SPACE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. CONSTRUCTION CERTIFIED BY DONALD G. FEILER, ARCHITECT ON 10/29/04. The certificate is issued to RUSSELL C WELLS JR & WF. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A u ori d Sig ture 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. 30459 Z Date JUNE 30, 2004 Permission is hereby granted to: RUSSELL C JR & WF WELLS GRAND AVE MATTITUCK,NY 11952 for AS BUILT ALTERATIONS TO AN EXISTING DWELLING AS APPLIED FOR at premises located at 1805 GRAND AVE MATTITUCK County Tax Map No. 473889 Section 107 Block 0008 Lot No. 041 pursuant to application dated JUNE 30, 2004 and approved by the Building Inspector to expire on DECEMBER 30, 2005 Fee $ 300 . 00 I rized Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT `�''' 2 9 2004 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, 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. //_ //S—/f 0`f New Construction: V Old or Pre-existing Building: (check one) Location of Property: 1703- 69.'RAMiv kt&t Tr keA y // 0fJ',� House No. Street Hamlet Owner or Owners of Property: 1 , ✓.rf l I 0�s 0011 w0c (& Suffolk County Tax Map No 1000, Section U-7 Y y 1 Block Lot Subdivision Filed Map. Lot: Permit No. 1[S' Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ a- - Applicant Signa re LY WITH ALL CODES OF COM RK STATE &OWN CODES APP ROV D AS NOTED NEW YO AS REQUIRED AND CONDITIONS OF DATE. B'P , SOUTHOLD TOWN ZBA FE SOUTHOLD TOWN PLANNING BOARD NOTIF BUILDING DEPARTMENT AT TOWNTRUSTEES 765-1802 SAM TO 4 PM FOR THE FOLLOWING INSPECTIONS: N.Y.S.DEC 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATE OCCUPANCY OR 4. FINAL - CONSTRUCTION MUST USE IS UNLAWFUL BE COMPLETE FOR C.O. EET CONSTRUCTIONALL REQU REMEWS OF THE CODES OF W WITHOUT CERTIFICATE RE DES GN ORE CONSTRUCTION(ERRORS. OF OCCUPANCY DES ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE JL NKi rnS CERTIFICATE CODES OF NEW YORK STATE. REQUIRED DONALD G. FEILER • ARCHITECT 11725 Main Rd•Box 1692•MatTituck,NY 11952•631-298-5453•Fax 298.1380 IL I 1 3 r w N I 'b It.11M G �►1vInIC� — � u Of- Y.+u y N� S EN>rRC�� ccml5t<RYATtoN co"ASTVL)c-Tlom Cp,p� Jest. i, 1°1 9 TL�PSLE .+, I Up,..,R ,o LJo PROVicep U O. 2? Uo O. 0'1 CEILI►.1C�" SPR oto) V,?..,. O'S, . 0 Ar Ntme �2 � VmT 7 To �t�. P�TOF M�?: Kavo�l�q�E. -C�I��o►.,�'r--�1',or,.� N C -- �� 6IR.6-10 >-/elAuG-) MbTrt rtuG,�-,► DONALD G. FEILER - ARCHITECT 11725 Main Rd•Box 1692•Mattituck,NY 11952•631-2985453•Fax 2981380 October 29, 2004 Mr. Gary Fish Town of Southold Building Department Town Hall, Main Road, Southold, NY Re: KNELLS RESIDENCE 1805 Grand Avenue, Mattituck B.P. # 30459 Z Dear Mr. Fish: I have examined the above mentioned project, and to the best of my knowledge, I can verify that is in compliance with NYCRR provisions at the time of construction. Donald G. Feiler ��\S�ERED ARS y/� F w. 01 , ',' K 'HSM `� �4 N'�• ,, ■■■■■■■■■■■■■ I. _ �iY- � �,;�,,,, , .. tai;:, ; -;�'•,. ■■■■■■■■■■■■■ ' a ■■■■ e �, .'° Jut.. t° ■■ I ■■■■iii®�_�■■� ■■ mi i■ E m m 1,W,i mmmlj�%K�Kl MIM ■■■■! ■■ Emilmom ■■■■r mom ■■■■■ ♦ a xtensi Y I • • • ! • ` TOWN OF SOUTHOLD P*OPERTY RECORD CARD _ OWNER STREET VILLAGE DISTRICT SUB. LOT t UssEcL C .EL Gam-- -9 esc.. FORMER OWNER N / . E ACREAGE W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. I IND. I CB. I MISC. Esta Mkt. Value LAND IMP. TOTAL DATE REMARKS d 4 / o 00 0 d �- � OQ 4 D 1 6 72- O 6 $ J,�" SOLD3P,S'oo. 1A1, 1. rS,VrEwsKi o C'•Wr`,L,Cs 1 R M AGE ,� U-p BUILDING COND PN .11 assr j Cr NEW NORMAL BELOW ABOVE FRONTAGE ON WATER C 5aa Farm Acre Value Per Acre Value FRONTAGE ON ROAD /o a- X l J--v — Tillable 1 BULKHEAD Tillable 2 DOCK ea Tillable, 3 nm*Iesn_ .q A e Woodland A re no — AOW— Swampland .rs Brushland House Plot Totol 7s5.,soz BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU N PLBG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: A DATE INSPECTOR Z � FIELD INSPECTION REPORT DATE COMMENT'S FOUNDATION(1ST) Z Ul 3 ------------------------------------ FOUNDATION(2ND) Ccl • S"i .t� • z c 0 On ROUGH FRAAMG& a � PLUMBING � y V] z � INSULATION PER N.Y. b � STATE ENERGY CODE y FINAL .S d �1 1 ADDMONAL C011MENTS m Z m �o 1 y d O lJ� z x ... x v ►moo y TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before 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 Survey www.northfork.net/Southold/ PERMIT NO. �� Check. Septic Form N.Y.S.D.E.C. p Trustees Examined '20 Contact: Approved ,20_� Mail to: Disapproved a/c Phone:a79-- 7 !y52 Expiration ,20_ uilding ct ` Ju%v 2 5 W APPLICATION FOR BUILDING PERMIT BLDG.DEPT. Date (P C , 20 L T WN OF§OUTHOLD 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 eas, ad 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 hafnot 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. (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder a Lam;FI F(L Name of owner of premises l�sf k l C'. �k d (�po l lv L LS (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: House Number Street Hamlet County Tax Map No. 1000 Section___Lo d Block Lot q Subdivision Filed Map No. Lot (Name) 2. Statd existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy C4n4e,F b. Intended use and occupancy P1 I L,4 /y l?o v rl 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 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 Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front ; 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 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 G/ / 14.Names of Owner of premises ftp �t. r Address It C1 r aF4,.K Air- Phone No. 5^7 Name of Architect Address Phone No Name 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 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) S: COUNTY O being duly sworn,deposes and says that(s)he is the applicant (Name of,individual signing contract)above named, w (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�hemanner set forth in the application filed therewith. Swo to before me 20� f Notary Public Signature of pplicant PA WIA &WIN Notary Public,State of New York No.01C0501I852 Ouafified in Suffolk County -- Commission Fimires cert 13,110 IOS