HomeMy WebLinkAbout31041-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30848 Date: 04/11/05
THIS CERTIFIES that the building DECK ADDITION
Location of Property: 2200 CENTRAL DR MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 106 Block 1 Lot 25
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 6, 2005 pursuant to which
Building Permit No. 31041-Z dated APRIL 6, 2005
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 EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to TOM LEVIN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized Signature
Rev. 1/81
Form No.6 ,(, �' _
'
TOWN OF SOUTHOLD
r ` � 5 _ �
WILDING DEPARTMENT
TOWN HALL 6
765-1802 { p
G.G. CCP7
APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOtJT"OLp
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 budding,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 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. 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- $25.00
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00,Commercial $15.00
*
as built" deck on street side Date. 04/06/2005
New Construction: * Old or Pre-existing Building: (check one)
Location of Property: 2200 Central Drive, Mattituck
House No. Street Hamlet
Owner or Owners of Property: Tan Levin
Suffolk County Tax Map No 1000,Section 106 Block 1 Lot 25
Subdivision Captain Kidd Estates Filed Map. 1672 Lot: 2
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: x (check one)
Fee Submitted: $ 25.00
�Applicant
�Signature
Co -?- 3o3 'f tr
3 / I 765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY
Q[ ] FIRE SAFETY INSPECTION
-a
REMARKS: "
DATE '"/ �g 0 s INSPECTOR //¢
.040 TOWN OF SG4THOLD ; tOPERTY CORD CARD
OWNtR STREET 02C) VILLAGE DISTRICT SUB. LOT 'jam
761.-1 ICU; (fe4PZ_7W d\/,e- /'l 6 TT, Tuc
FORMER OWNER N E ACREAGE
ye U;7a///c Lars / j
_ S W TYPE OF BUILDING
RES. �� O SEAS. VL. FARM COMM. IND. I CB. I MISC. Est. t. Value
LAND IMP. TOTAL DATE REMARKS v d 3
® L 9860
1440o /,Sa p d d „ L.� s%�/7s Seip NAM,L• T. L t vl& io /1, G EUNDL �-o�es.
ef e) d 0� Y� �W ��L'd S-cd��✓e�`reu i airs a�eu, t3
3266 3 a0 6300 6 1);1741
AGE BUILDING CONDITION = a72o
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Y' 6 c 3 (76
40 —FM
Farm Acre Value Per Acre Value FRONTAGE ON ROAD 16
Tillable 1 BULKHEAD
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot
Total
All
H- I
I
L li
I '
336 -
—Basement
3 b Foundation Both ► • + ou
vao��e
= i �6 X ZQ = �� YOQS� Basement --- _ Floors .� F(a tfaK o —
enrX 12 ' �36 j Ext. Walls — Yt Interior Finish_
Extension Fire Place Heat
--I �fee,l F! .2 ECa y9�_c��►I
--------- Porch Roof Type26 z 1
Porch Rooms 1st Floor
Breezeway Patio Rooms 2nd Floor
Sara9 e Driveway Dormer
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. 31041 Z Date APRIL 6, 2005
Permission is hereby granted to :
TOM LEVIN
159W 88 ST
NEW YORK,NY 10024
for
CONSTRUCTION OF AN AS BUILT DECK ADDITION AS APPLIED FOR
ADDITIONAL CERTIFICATIONS MAY BE REQUIRED.
at premises located at 2200 CENTRAL DR MATTITUCK
County Tax Map No. 473889 Section 106 Block 0001 Lot No. 025
pursuant to application dated APRIL 6, 2005 and approved by the
Building Inspector to expire on OCTOBER 6, 2006 .
Fee $ 300 . 00
4n
Authorized Signature
ORIGINAL
Rev. 5/8/02
FIELD INSPECTION REPORT DATE COMMENTS
V`la
FOUNDATION(1ST) - — ----- -- -- -- — — 14
FOUNDATION(2ND) m s
U
----------
ROUGH FRAMING& m3
PLUMBING
INSULATION PER N.Y. --
STATE ENERGY CODE — —
FINAL -- --- -
ADDITIONAL COMMENTS
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O Y
O
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x
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TOWN OF WTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of IIealth—
SOUTHOLD,NY 11971 a sets of Building Plans___
TEL: (631)765-1802 Planning Board approval___
FAX: (631) 765-9502 Survey
www,northrorlLnetlSouthold/ PERMIT NO. (O /2 Check___
Septic Form
N.Y.S.D.E.C. _
Trustees _
F•,xamined � ,20� Contact:
Approved_ 20__ Mail to:_
Disapproved a/c_ _
Phone: fS 7
r
16Expiation / 6 ,20 ni ��
-- Liu APR
B - 6
uildin InZa 1!_
APPLICATION FOR BUILDING PERMIT -
Date April 6 20 05
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 Pemut.
d. Upon approval of this application. die Building Inspector will issue a Building Permit to the applicant. Such a permit
small 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 die
property have been enacted in the interim,die 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 Pennit 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-- r�i"mee,if a corporation \
PO Box 1181 , Cutchogue, NY 11935
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
attorney for owner
Name of owner of premises Tom Levin
(As on the tax roll or latest deed)
If applicant is a corporation, signature of drily 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
_ 2200 Central Drive, Mattituck
House Nwnber Street Hamlet
County Tai Map No. 1000 Section 106 Block 1 Lot 25
Subdivision Captain Kidd Estates Filed Map No. 1672 Lot 2
(Name)
See Eileen Santora & Joseph Fischetti, PE plans & certification submitted herewith.
A
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction
1. ESIStltlg use and OCCupBttC}' Private one-family dwelling
b. Intended use and occupancy Private one-family dwelling
"as built" deck on street side
3. Nature of work (check which applicable): New Building Addition x 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. Dimbttsions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear _
Depth Height Number of Stories
7'8" x 15'10" as built deck on street side
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front 120.00' Rear 78.12' Depth 594.88' or 560.82'
10. Date of Purchase 1980 Name of Former Owner Freundlich & others
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO x
13. Will lot be re-graded? YES_NO x Will excess fill be removed from premises? YES_NOx
14. Names of Owner of premises Address Phone No.
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)
SS
COUNTY OF Suffol
Deborah Doty being duly sworn,deposes and says that(s)he is tate applicant
(Naive of individual signing contract)above named,
(S)Heisthe attorney
(Contractor,Agent,Corporate Officer,etc.)
of said owner or owners, and is duly authorized to perforat 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
perforated in the manner set forth in die application filed therewith.
Sworn to before me this
day of A�20 OS
l
o4 p Signanrre of Applicant
SUSAN J, NAQY
Notary Public State of New York
No.4896735
Ouallfted In Suffolk County
Commission Expires May 2007
� w ACE
Eileen Santora • Residential Designer doesph Fieahoul, FE
631'734-2794 • Cuuhogue, NY 1725 HoOwP R*pd • vowthoW, NY 11871
631.765-2564
aa��zr�c cee�ficRr�u mays-e —
ALL CONSTRUCTION SHALL
M ET THE CODES OF NEW YOR 5 ATSH
APPROVED AS NOTED
DATE:__: � B.P.11
FEE:' Qd_ BY: %�P�.
1 NOTIUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
1 FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
1 3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
i' YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
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P � COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
jc -I �G L1 . 1i4 __. SOLTHOLOTOWN ZBA
16 SOL'- _ . �„ ,PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
N.Y.S.DEC
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L�`--- -- — T
;,4 ,,- --- . _ ,. . -- _ - -- - _1 OCCUPANCY OR
USE IS UNLAWFUL
�� YouRt?,r� coL Lze �x,ntil �u�� WITHOUT CERTIFICATE
OF OCCUPANCY pF NEK,y
'Il-_f gti� F OH,c �9
a,
FLOOD ZONE N =7
!' L
2' f" J�_. '- COMPLY WITH CHAPTER '46" O x•. 052 `
I:: rl4" = I ''-I;`h FLOOD DAMAGE PREVENTION �QFESSrO
SOUTHOLD TOWN CODE.
L.L-VIN 15 C-)f–Ck� °LAS �Ui Ll"u
INTI
bAPPRGVEG GY'
SCALE' � _ ICU GRA WN EY �:>2T.
DATE A`Ir; I- � " REVISED
DRAWING NUMBER
I
SURVEY OF LOT 2ry
MAP OF CAPTAIN KIDD ESTATES d , ,
AT MATTITUCK INLET ,���ti WE
FILED JANUARY 19, 1949, MAP No. 1612
SITUATE: MATTITUCK
TOWN: SOUTHOLD �Oj
SUFFOLK COUNTY, NY V0
SURVEYED 03-02-2005
SUFFOLK COUNTY TAX #
1000-106-1-25 ria
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NOTES
MONUMENT FOUND
ELEVATIONS REFERENGE SUFFOLK COUNTY TOPO MAPS
AREA = 56,156 sf or 129 acres r ".11'
/A
JOHN C. E]HLERS LAND SURVEYOR
61RAPHIC SCALE 1,, 30' �:, r T.k4� '� 1 6EAST MAIN STREET N.Y.S.LIC.NO.30202
rQj RIVERHEAD,N.Y. 11901
369-8288 Fan 369-8287 REF;\\EIp server\d\PROS\OS-128.pm