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HomeMy WebLinkAbout31004-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30861 Date: 04/19/05 THIS CERTIFIES that the building ADDITION Location of Property: 15705 MAIN RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 1 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 17, 2005 pursuant to which Building Permit No. 31004-Z dated MARCH 17, 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 REPLACE EXISTING PORCH ON SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to APRIL M. ROSS & JAMES E. MCHEFFEY (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 �I I ' TONi1V OF SOUOUTHOLD L u APR nrn U BUILDING DEPARTMENT TOWN HALL ra' 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be tilled 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 litres, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 forst). 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 14,u lead. 5. Cotmnercial 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 Planting 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: L 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 L 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 i 'Dat/e. _ — 30 - 0 � New Construction: Old or Pre-existing Building: // (check one) Location of Property: / ,r7C7,S ti/aaN a-f �r'fw , 4 K House No. Street Hamlet Owner or Owners of Property: +R " I M �o S 5 e( Flo ote.5 Z Suffolk County Tax Map No 1000, Section //S Block 0001 Lot L9 O Z Subdivision Filed Map. Lot: Permit No. 3 DateofPenrit. 3-23-0}— Applicant: TAwve.S +Atc4e-act� f}jo1 r ( 2oSS Health Dept. Approval Underwriters Approval Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Z S -- Applicant Signature t .D INSPECTION_REPORT-_ -DATE===' _-==ie___sa=a_==------ COMMENTS= N TWKDATION ( IST) tl H tl Ql a foDNDATION (2ND) p N N u ?,*GH FRAME b n U PLUMBING tl Y �u N N C yp q plSULATION PER N. Y. Y H STATE ENERGY M Y CODE tl N tl � p 3- A p lfq y n tl p X tl q �p FINAL a u __-- ADDITIONAL COMMENTS: i 0 z 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. 31004 Z Date MARCH 17, 2005 Permission is hereby granted to: ELAINE ROSS LORETTA 15705 MAIN ROAD MATTITUCK,NY 11952 for DEMO. EXISTING PORCH & CONSTRUCT NEW PORCH (IN KIND) ON AN EXIST. ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP25916 . at premises located at 15705 MAIN RD MATTITUCK County Tax Map No. 473889 Section 115 Block 0001 Lot No. 002 pursuant to application dated MARCH 17, 2005 and approved by the Building Inspector to expire on SEPTEMBER 17, 2006 . Fee $ 150 . 00 ut or ed Signat ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET -, VILLAGE D T—.F— SUB. LOT FORMER OWNER N E ACR. S W TYPE OF BUILDING S• 2 SEAS. VL. FARM COMM. CB, MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS r , r!- vo 8.'J.s z — d 04 1 I z.c. I I x �9i 7 av r • . k, �� I AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH =HousePlot BULKHEAD DOCK _ COLOR TRIM cU ' I I \ - --- - -- — _T M. Bldg. — — — -4- Extension } — Extension ----- - T -- — -- ---- — Extension ---- — r — — — ' Extension Foundation (Bath Dinette ''. Porch Basement Floors / K. JS" � ' Porch O �Ext. Walls Interior Finish ! j LR. Breezeway Fire Place Heat 5 SDR. T—' Garage Z T ;, e Type Roof --� Kooms lst Floor ER. — � I I Patio Recreation Room Rooms 2nd Floor FIN. B O. B. (Dormer ^~ Driveway i 1 Total I 1 � APPROVED AS NOTED DATE: 99 B.P. A --- N )TIFY BUILDING DEPARTMENT AT 785.7802 9 AM TO 4 PM FOR THE �1 FOLLOWING INSPECTIONS: 1 I FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING GO 8. INSULATION Z \ 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. r t ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. C STATE CONSTRUCTION & ENERGY lC1 l ODES. NOT RESPONSIBLE FOR ESIGN OR CONSTRUCTION ERRORS L x raj (� C r OCCUPANCYOR ' i N USE IS UNLAWFU I � Wfco ' 11T CERT1Fd.. OF JPANCY pI q i r- 0 14 j; v 1 f 4 t Gx�SfiNL '4 �'� r POS- I �D^\D CCA e� r .� ICA ` � �"CjN . �W's7Cs w{C-HGi �/ iryyN -..irlf^ rp so v; I(a,�L la �� I(Arq ,5-705' „ jm,"�j IZ A ii4SZ 3l �Q9 . z.�sP.c.c,f-o2 ,jou-��a ( oQ �-Ownl Sum ��.ol ,Q N Y 5:2 ort v`Ia.do�w� , _ + k o.-S (y q � l 4o o,., r -f'L ., -I'�r t r e 1C i 5+ 5, t�ti1 oJ�¢ �1 b s�¢2rv� � o-4+hc.(,c- p Dvr lJro�4n+V . . 1 #417 1 p ,rL�.. + r '�Vt pMAL,, i o g m1a...�,✓ e-lZ a jrAE- Q +L4L the t pa 2'--k ;r j 0.g r .OL. rr OLR-wv.i '�. v porgy/' C..O .."�J (t- ��D.J �+S �a ''F'c�. � a_.K 4-0 i n i�ti� l�a.�f o tt.'ct �er c� � s ILC-f,',.._► PC-et- ?I t-c,-s C-ti?I.Lc.sc a.cc-c--p f -rc" fiU"tcrQ.ui¢�� [ Q W w.te../Cs, J-c.A-4- S A-A �-.� r ( tot �IR- AD w +c, ye of .�� .1 nc sple-"F-7 cl^1 . \-j A.- Co ri yt- re� �1.._.Q 63/- Z58 -0226 lccY- s eye Yo ( - 8Y"( - 333T �wceE �aYS� /i -� �.¢ \� rte. s p o�, s� � -E-5...; s R�•�t s-� . t-/ Ress I .T_ �o��OF SOUfo�a 3 100 ©atF� ���ouxir TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ( ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING KFINAL Qpolec '% [ ] FIREPLACE & CHIMNEY [ ) FIRE SAFETY INSPECTION REMARKS: 2s;�� � d DATE INSPECTOR �2T-- ---- -7- i __.. BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . -J TORN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . - —j BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . __ .... � TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . - -- SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL Examined Examined.................. 19.... D�y MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved......$:.y........ 1918 Permit No. . 1. �� .................................... Disapproved a/c .................................. .................................... (Building Inspector) PPLICATION FOR BUILDING PERMIT ([� Date. . -� .rdn4. . . . . , 197n .q. INSTRUCTIONS a. This application mint be completely filled in by typewriter or in ink and submitted to the Building Inspector wit] 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan shaving location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application my not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector trill issue a Building Permit to the applicant. Such 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 arty purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tam of Southold, Suffolk Canty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for reveal 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 buil`dGin54or necessary 'ssinspections. ........ (Signature of applicant, or name, i a corporation) V2 `:11ra..cnATLTuclx4.....1 A RZ Z- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 1L.....�e.wba.At ••.........-............................................................... Name of owner of premises .Ai�-AJNC...-. ........................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ..1*................................................ (Name and title of corporate officer) Builders License No. ...... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 5 �uCQ I. location of lad on which proposed work will be done....../....... ,s........../t-(0- L. .../�............................ ....................vl.4t�.r�s....ki,q ....... ?. i<<?G .... House Number Street Hamlet County Tax Map No. 1000 Section .I.L5........... Black C,z l........... let (:�77....... 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 :rlY)lj-\(.... E5 1DLNC.1 ......................... b. Intended use and occupancy ..S a-b,9J AF....i:AM Lt.4..... z5.ln{FJ`+lS,................... 3. Nhture of �nC (check which applicable): New Building ......... Addition .......... Alteration .. ........ Repair .✓......... Removal ............. Demolition ............ Other Work .................................. �� -��-,V,yy__ (Description) 4. Estimated Cost .... =f� .............. fee .............................................. ([o be paid on filing this application) number5. If dwelling, number of dwelling units . .......... Naber 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...................... i .. 7. Dimensions of existing structures, if any: Front-.33..51...... Rear ............... Depth -T.0,m........ I Hkigtnt Af,).................... Nmnber of Stories ..(.................... Dimensions of sane structure with alterations or additions: Front 5AMC_.... Rear ............... Depth .................... Heiglmt .................... Number of Stories ............... 8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Neer 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: .W.C)................. 13. Will lot be regraded ...N.V........... Will excess fill be removed from premises: YES ND)°°77 14. Names of Owner of premises .lalra9JAICf..`-V fflOAddress .S0 ..`..(�.I Ptq"C ..PQ.. Phone No. Name of Architect .................................... Address .............................. Phone No. .............. Nam of Contractor ................................... Address ...............................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO .X...... *IF YES, SWMD MM TRIMMS PERMIT MAY HE REQUIRED. PI.OT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street aid block number or description according to deed, and show street names and ind'eate whether interior or corner lot. CC ,T Fbec_H — STiay Nc� wrr �� t_'�cI5'�i tv� k Cbz, Sum OF NSl Y(W, Co1N[Y OC -s,,Ffch`.. ......... Ss ...1 t:klM!\SAS... .....�:'-'U��V I"f...............lhe hung duly swum, deposes and says that the is Lime applicant (Name of individual signing contract) above nand, Ile is the ..CaUA1TEAGV.�......................................................................... (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 mamner set forth in the application filed therewith. Sworn to before me this �7ry y.s -......1°••=......day �1 ^ 4...... lg.,?? .... Notary Public ..................................... .. d/ ..��.�1./ ... / , PETER M. COLEMAN "11!!ee NOTARY PUBLIC, Smola of Now York (Signature of Applicant) No. 52-5758570 Quolified in Suffolk County k Commission Expires March 34 jOD� R 8/08-085628 Ug1)lv62 0 MANOR 13659 ,. p) . 5 LpGE IE N0• BD,0;- �" .t 0 50 .01 1 = B.o N, A �- t. z• + g u. ybg .v ' • Z m O N \ 2 C" ' m e � f"' to D } m G� o m � bl� c D 1 d4 r0 r - P N Z r Hse m Z Mnauthorized alteration or addition to this survey N a viola. m \ \ 00 5 tion of section 7209 of the New York State Education Law. Copies of this survey map not bearing the land surveyor's p { E Inked seal orembossed seal shall not be considered to be a valid copy. c •40 Guarantees or certifications indicated hereon shall run only / •4 . 42 N to-the person for whom the survey is prepared,and on his d 5 53 A y G 5 behalf to the title company,governmental agency and len. n Q N ding institution listed hereon,and to the awigness of the lending Institution. Guarantees or certifications are not It titer N , transferable to additional institutionsorsubseptlerdovlrttsrs. Y' ^ 1000- 115- 01- 02 SURVEY FOR REFERENCE ELAINE ROSS & ✓Acoun/NE PLEET AT MATT/TUCK TOWN OF SOUTHOLD f JAL. 9UARANTEEO TO, SUFFOLK COUNTY, N.Y. `'fit } CHICAGO T/TLE INSURANCE COMPANY SCALE : 1"230' * ELAINE ROSS B ✓AC04VEL INE PL EE7 * -- . JULY 30, /98/ t^� �' LSI8125 �-L LAND 30MVEYON 8FG LAND `_ .t N.Y& LIC.NO.20rrd RIVERHEAD N.Y. i BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Q Owners Name: OS`J L� tit, -Reviewed: ' 4 g Architect/ Date . Engineer: Submitted: SCTM#: District: 1 000 Section: 11,5 Block: I Lot: Project Subdivision Location: JS 1oS Mr41N g6#90Name: Single&separate Requir L certification: Yes o C/ !-5T� y I Req. Zoning District-.R'40 [Lot size: Actual: s 2AC e [Lot coverage M Proposed: Req. 1000, Req- [F ont Yazd 3,5 Proposed: (Side Yard �b is Proposed: 1 [Rear Yard �g' Proposed: Project Description: CaQr4eb f'ZI I PdAC'� ?ePL4CvM&K'&K'— AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees i Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: t� Ot