HomeMy WebLinkAbout31319-ZFORM TIO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31106
THIS CERTIFIES that the building ACCESSORY
Date: 08/15/05
Location of Property: 680 WESTVIEW DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 139 Block 1 Lot 15
Subdivision
Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 25, 2005 pursuant to which
Building Permit No. 31319-Z dated JULY 29, 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" ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to THEODORE WITHUS,JR.&KATHLEEN M.BALAS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF NEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
Authorized Signature
Form No. 6 i
TOWN OF SOUTHOLD i
BUILDING DEPARTMENT LI AUG I I !i l� i`
TONNIN HALL I
765-1802 L t
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application [oust be tilled in by typewriter or ink and subttutted to the Building Department with the followine:
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 fonn).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement front plumber certifying that the solder used in system contains less than 2,10 of Pb b lead.
5. Conuttercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Contpliance fiont architect or engineer responsible for the building.
6. Submit Planning Board Approval of conipleted site plan requirements.
B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses:
L Accurate sur ev of property showing all property lines, sweets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect sighed by the applicant. 11'a Certificate of ( )ccupanev is
denied, the Building htspector 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
Swimming pool $25.00. Accessor, building $25.00. Additions to accessory bui
2. Certificate of Occupancv on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. 'remporary Cenificate of Occupancy - Residential $15.00, Conuneteial $15.00
New Construction.
Location of Property: G J'O IZ
Hoose No.
Old or Pre-existing Building:
Alteranon� to duelling $25.00.
ging $25.00, Businesses $-50.00.
Date.
(check one)
/o7S2
/ Hauilet
Owner or Owner; of Property: _T e-0
Suffolk Count} Tax Map No 1000, Section 13q Block I Lot 15
Subdivision _
Pemut No. .313 Iq – Date of
Health Dept. Approval:
Planting Board \pprovaL
Request for: Temporary Certificate
Fee Submitted:. 4-6,–
R.jk . w/(0
C6 ?-3110(0
Filed Map.
_ Lt _
Applicant:_7kre—UJr ti s, Jr.
Underwriters Appro�ar
Final Certificate: V (check one)
Applicant Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 31319 Z Date JULY 29, 200
Permission is hereby granted to:
T WITHUS JR
PO BOX 904
MATTITUCK,NY 11952
for :
"AS BUILT" ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED
FOR
at premises located at 680 WESTVIEW DR MATTITUCK
County Tax Map No. 473889 Section 139 Block 0001 Lot No. 015
pursuant to application dated JULY 25, 2005 and approved by the
Building Inspector to expire on JANUARY 29, 2007.
Fee $ 150.00
� � r�
Authorized Signature
ORIGINAL
Rev. 5/8/02
p •.
9_ /_/s TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET
VILLAGE
DIST.
SUB. LOT
� W I i5 �
IMP.
TOTAL
DATE
Q
FORMER OWNER
N
6. h Mc cou,Ier
E
R.
ACR.
P�cN, iT 3r o u G CO5 033
S
thus
S
Wes
W
TYPE OF BUILDING
d .A
G
0APG
Oo e
RES.r11
SEAS.
VL.
FARM
COMM. CB. MICS. Mkt. Value
LAND
IMP.
TOTAL
DATE
R RKS
o p
��
/ (� 0 U
5-
P�cN, iT 3r o u G CO5 033
0
1�vo
% 0 0/21S17J',1P',a�a
77
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yo o
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rf S
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sc 4
011 1034-1a33 44 - 4 -
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II(,A�''r ,
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se-4e-4
3 a�o5- 1 /I Cf)OIAlr� ✓-� Wf ��/u S7 s - i'Ci .»s ddhtra 4e -4 -
Tillable
FRONTAGE ON WATER
Wuodia„d
FRONTAGE ON ROAD
/V p
Meadowl,ond
DEPTH
House Plot
BULKHEAD
Total
M. Bldg.
Extension
Extension
Extension
Porch
Porch
Breezeway
Garage
O. B.
Total
Arl
COLOR
I1 1m. I1 '
W_ _
TRIM
FIELD INSPECTION REPORT DATE COMMENTS
U,!
�m
FOUNDATION (1ST)
- ---
--- _ ---- --- --_-- _ _---
,:�
a
--------------------------------------
-
FOUNDATION (2ND)
m
z
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-
ROUGH FRAMING &
m
PLUMIBING
--- - -- - - -- - - -- ---- - - - - --
1T
INSULATION PER N. Y.
r
m
STATE ENERGY CODE
----
--- - -- ------ - - - ---- ------
FINAL
--- ---
ADDITIONAL COMMENTS
- - --
O
z
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1
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�►31q z -
76S -1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: '
DATE 7-3-6-5-- INSPECTOR
TOWN OF SOUTHOLD
BUILDING DEVARTMENT
TOWN HALL
BUILDING PERMIT APPLICATION CHECKLIST
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northforlk.net/Southold/ PERMIT NO. 3/3/ ! -6�
Examined '200)
Approved— ,20 ,SS
Disapproved a/c_
Expiration , 20&
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans_
Planning Board approval
Check_
Septic Form_
N.Y.S.D.E.C.
Contact:
Mail to:
Building Inspector
JUL ,L 5 2 APPLICATION FOR BUILDING PERMIT
t4' Date .ruL`/ 22
�-- , 2006
t' INSTRUCTIONS
a. T>I is pplication 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 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 has not 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.
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises t heodore WAuS, Jr. AAd t(et.Aleol &46
(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 N
Other Trade's License
1. Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section 13q Block I Lot 15
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construct4on:
a. Existing use and occupancy S I O RR6E 51+6D
b. Intended use and occupancy 5-rO R R fr F S K Eb
3. Nature of work (check which applicable): New Building Addition Alteration
Repair_ Removal Demolition Other Work "A5 Au+wr" .5/4 ED
0 2063 (Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units N A Number of dwelling units on each floor NA
If garage, number of cars NA
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. NIA
7. Dimensions of existing structures, if any: Front 11' .3" Rear /1 .3 �+ Depth lG + 4 11
Height _ills" Number of Stories 1
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 100' Rear J00 ��Depth 150'
10. Date of Purchase 9� A/ 1981 Name of Former Owner WI C0146 Brus/c! d J011n Al- &SCA
1 I. Zone or use district in which premises are situated flGstdex F,a I
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO x
13. Will lot be re -graded? YES_ NO A Will excess fill be removed from premises? YES_ NO_ 1✓A
14. Names of Owner of premisesT+todol'e kJrr-husJrgddress 1292rk Ara+ k/+/1'S�on�e No S/(*_ t1y0-µ94M
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 X
* 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 dN KNOW l�
* IF YES, D.B.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 PI4,69Qb1)
Theodore (,tA+IL L,S, j—r-• being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
Agent, corporate Utttcer, 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 manner set forth in the application filed therewith.
Sworn to befon; me this
*Z`L day of 7U14 20 0 Sl
UN�otary Public Signatu a of Applicant
Noary Isu iEt�D6LEYork
Con? 1 m MS `�do t�; JlaW__
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1 S(ORY FRNME
GARAGE
HOUSE &
SURVEY OF PROPERTY
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MATTITUCK
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SUFFOLK COUNTY, NEW YORK
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S.C. TAX No. 1000-139-01-15
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SCALE 1 "=30'
9C
JUNE 29, 2005
-
AREA = 14,888.19 sq. ft.
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0.342 ac.
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CERTIFIED TO:
DAVID BEREZNY
TRACI BEREZNY
MCS MORTGAGE BANKERS, LLC
m
MADISON TITLE AGENCY, LLC
10.2
SURVEY OF PROPERTY
SITUATED AT
MATTITUCK
'1 �•N
TOWN OF SOUTHOLD
Og°�°5'�
S.
SUFFOLK COUNTY, NEW YORK
tro`7
S.C. TAX No. 1000-139-01-15
•�. O
SCALE 1 "=30'
JUNE 29, 2005
�
AREA = 14,888.19 sq. ft.
J
mm
0.342 ac.
�n
CERTIFIED TO:
DAVID BEREZNY
TRACI BEREZNY
MCS MORTGAGE BANKERS, LLC
m
MADISON TITLE AGENCY, LLC
10.2
UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI-
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE.
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
PREPARED IN ACCORDANCE WITH THE MINIMUM
STANDA S FOR TITLE SURVEYS AS ESTABLISHED
BY TH L.I.A.L.S. AND APPROVED AND ADOPTED
H USE BY THE NEW YORK STATE LAND
�P' o OR f y IATION.
5 '6QH A.
KOC,
i
X—*
m
N.Y.S. Lic. No. 49668
Joseph A. Ingegno
Land Surveyor
Title Surveys - Subdivisions - Site Plans - Construction Layout
PHONE (631)727-2090 Fox (631)727-1727
OFFICES LOCATED AT MAILING ADDRESS
322 ROANOKE AVENUE P.O. Box 1931
RIVERHEAD, New York 11901 Riverhead, New York 11901-09
25-2-
15
23.4'
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L=169.30'
coNc•
19 s o.2 AaN4 BICE ��
UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI-
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE.
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
PREPARED IN ACCORDANCE WITH THE MINIMUM
STANDA S FOR TITLE SURVEYS AS ESTABLISHED
BY TH L.I.A.L.S. AND APPROVED AND ADOPTED
H USE BY THE NEW YORK STATE LAND
�P' o OR f y IATION.
5 '6QH A.
KOC,
i
X—*
m
N.Y.S. Lic. No. 49668
Joseph A. Ingegno
Land Surveyor
Title Surveys - Subdivisions - Site Plans - Construction Layout
PHONE (631)727-2090 Fox (631)727-1727
OFFICES LOCATED AT MAILING ADDRESS
322 ROANOKE AVENUE P.O. Box 1931
RIVERHEAD, New York 11901 Riverhead, New York 11901-09
25-2-
2' x 6" ROOF FRAMING
TYP.
2' x 4" STUDS
16" ON CENTER —
ROLL—UP DOOR I
( 7-9-3/4" WIDE
961
D � � c
5/8" PLYWOOD ROOF
WITH ASPHALT SHINGLES
Io" ^' wWOOD SIDING
AINUM SIDING
D FLOOR PLAN
L-► C
V 32' x 20" —
= 8 -1'- \
IRE
JLB
G)
x 4" SOLE —
(TYP.)
FLOOR TO CEILING = 8'-1"
r /Q" PLYWOOD ROOF
ASPHALT SHIN(
2" x 6" ROOF FRAMING
SECTION A -A
�1/2" SHEET ROCK CEILING
!' CONCRETE SLAB ON GRADE J
APRON
7'-6")
SECTION C -C
2" x 4" PLATE
_ET (TYP.)
14-2 W/GROUT
. vllCRETE SLAB OP
''' � 4" BLOCKING
2" x 4" STUDS
16' ON CENTER (TYP)
- POWER TO LIGHT FIXTURE
-14-2 W/GROUND
LIGHT SWITCH
OUTLET (TYP.)
DIRECT BURIED CABLE FROM HOUSE
(11OV, 3PH, 60HZ)
SECTION B -B
2" x 6'
INCL—JP DOOR OPENING
7"-9 3/4" W x 6'-10 3/4"
WINDOW 32" x 20'
1/2"0
ANCHOR BOLT
(TYP.)
12'
CONCRETE SLAB ON GRADE —
WE
0
!' CONCRETE SLAB ON GRADE J
APRON
7'-6")
SECTION C -C
2" x 4" PLATE
_ET (TYP.)
14-2 W/GROUT
. vllCRETE SLAB OP
''' � 4" BLOCKING
2" x 4" STUDS
16' ON CENTER (TYP)
- POWER TO LIGHT FIXTURE
-14-2 W/GROUND
LIGHT SWITCH
OUTLET (TYP.)
DIRECT BURIED CABLE FROM HOUSE
(11OV, 3PH, 60HZ)
SECTION B -B
2" x 6'
INCL—JP DOOR OPENING
7"-9 3/4" W x 6'-10 3/4"
WINDOW 32" x 20'
'h
Ah
43534 ,
< OF NEWT
12° 0 1 2 4
SECTION D -D
;NICY OR
INLAWFU�
IT CERTIFICATE
UPANCY
—OUTLET (TYP.)
PROVED AS NOTED
4�413.p.11 3i 3/�9
r,5v . BY,
UILDING DEPARTMENT AT
8 AM -r O 4 PA FOR THE
NO IN` 7IC:'3:
ATION WO REQIPRED
)URF 'NCRFTE
2.IiODU - FF ,L�,'�G & PLUMBING
3. INSULATION
4. FINAL - CGP �IhPION MUST
BE COMPLEF _ FO,, ..0.
' ALL CONSTRUCTION SHr,LL MEET THE
REQUIREMENTS OF THE(, DES OF NEW
YORK STATE. NOT F,- .�aSIBLE FOR
EXISTING STORAGE SHED
AS -BUILT
680 WESTVIEW DRIVE
MATTITUCK NY, 11952
CERTIFICATION OF
NAILING & CONNECTIC
REQUIRED.
1/2"0
ANCHOR BOLT
(TYP.)
12'
CONCRETE SLAB ON GRADE —
'h
Ah
43534 ,
< OF NEWT
12° 0 1 2 4
SECTION D -D
;NICY OR
INLAWFU�
IT CERTIFICATE
UPANCY
—OUTLET (TYP.)
PROVED AS NOTED
4�413.p.11 3i 3/�9
r,5v . BY,
UILDING DEPARTMENT AT
8 AM -r O 4 PA FOR THE
NO IN` 7IC:'3:
ATION WO REQIPRED
)URF 'NCRFTE
2.IiODU - FF ,L�,'�G & PLUMBING
3. INSULATION
4. FINAL - CGP �IhPION MUST
BE COMPLEF _ FO,, ..0.
' ALL CONSTRUCTION SHr,LL MEET THE
REQUIREMENTS OF THE(, DES OF NEW
YORK STATE. NOT F,- .�aSIBLE FOR
EXISTING STORAGE SHED
AS -BUILT
680 WESTVIEW DRIVE
MATTITUCK NY, 11952
CERTIFICATION OF
NAILING & CONNECTIC
REQUIRED.