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Home My WebLink About31298-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31162 Date: 09/14/05 THIS c~RTIFIES that the building ALTERATION TO ACCESSORY Location of Property: 11305 MAIN RD (HOUSE NO.) (STREET) Co%~nty Tax Map No. 473889 Section 142 Block 2 Subdivision Filed Map No. Lot No. MATTITUCK Lot 19 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated J~3LY 15, 2005 pursuant to which Building Perm/t No. 31298-Z dated JULY 21~ 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" ALTERATION TO AN EXISTING "NON-HABITABLE ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to GEORGEANN PACKARD (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPART~ENTOFWRALTHAPPROVAL N/A EI~t-laICA5 CERTIFICATE NO. 101890H PLLg~ERS C~KTIFICATION DAT~o N/A o9/o3/o5 Authorized Signature Rev. 1/81 Form No. 6 TO'~Tq OF SOUTHOLD BUILDING DEPARTMENT TO~,VN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Tiffs application must be filled in by typewriter or ink and submitted to the Building Department with the follo;ving: 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 Under, vriters. 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 applicaat. If a Certificate of Occupancy is denied, the Building Inspector shah 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 dwelliug $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 ate. New Construction: Old or Pre-existing Building: __ ~ (check one) LocationofProperty: ![~0~ ~/~;ex /~O~t~; House No. Street Owner or Owners of Property: _~(~5~ ~1PX Suffolk County Tax Map No 1000, Section Subdivision Permit No. y(',~ ~,_~,~_ Date of Pem~t. Health Dept. Approval: Hamlet Filed Map. Lot: Unde~vriters Approval: Planning Board Approval: Request for: TemporaD' Certificate Fee Submitted: $ Final Certificate: / (checkone) .~~t Signature - -- TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING ~X~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ DATE ~'-' / ~-~ ~ -~' . INSPECTOR Electrical Inspection Certificate Electrir, al Inspect]on Service, Inc. Application 375 Dunton Avenue 101890H East Patchogue, New York 11772 (631) 28~6642 Issued To: Mrs. Georgeann Packard Street: 11305 Main Road Village: Mattituck Zip: Section: Block: Lot: Contractor: 11952 Town: Southold Lic.# Was examined and found to be in compliance with the National Electrk:al Code. Commercial [] NVDefects [] Pool [] lstFloor [] Indoor [] B;mement U HotTub Residential [] Dec Garage [] Attic [] 2nd Root [] Outdoor [~ Addition [] Survey Switches Receptacles F'rxtures GFI Heaters A/C Fans 3 9 2 Dishwasher Vi~sher/Amps D~Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector Bldg. Permit: Oamr Equipment 3ne room cottage / 1 sub panel Hugo s.USurdi President Rough [nspectJon: 08/18/2005 John Mc Mahon III Final Inspe~oo: 09/01/2005 In~: John Mc Mahon III This cedific, at~ must not be altered in any manner. Inspectom may be identified by their credentials. 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. 31298 Z Date JULY 21, 2005 Permission is hereby granted to: GEORGEANN PACKARD PO BOX 648 MATTITUCK,NY 11952 for : ALTERATION TO A/~ EXISTING ACCESSORY GARAGE AS APPLIED FOR. THIS IS A NON-HABITABLE GARAGE, NO SLEEPING PERMITTED. ADDITIONAL CERTIFICATION REQUIRE at premises located at County Tax Map No. 473889 Section 142 pursuant to application dated JULY Building Inspector to expire on JANUARY Fee $ 150.00 11305 MAIN RD MATTITUCK Block 0002 Lot No. 019 15, 2005 and approved by the 21, 2007. Aut horize~e~' ORIGINAL Rev. 5/8/02 I COMMENTS FIEED INSPECTION REPORT I DATE I FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING . INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ~wv. nor thfork.net/Southold/ Examined 20 Approved ~ , 20 Disapproved ac Expiration ,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, betbre applying'? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BUILDING PER~IIT Date INSTRUCTIONS [ ¥ ,20 a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 afier 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 buildin, g for necessary inspections. '~ (,/{~' ~/~. (S~namre of applicam or-namWe, ifa co~oration) (Mailin[g address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 4 J (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 ~vJfich propgsed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block 19 ~ Filed Map No. Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of propo,sed construction: a. Existing use and occupancy 5-{'O/ a q6~ ( ~r,~[xctl(b qa//¢.~;, ~ .fin')Ix, 5a ,[ ~ ~4 Cr'~l ~q b. Intendeduseandoccupancy~ ~fli t~ ~ ~ ~d ff ~ 3 ~J Ma~ DO~ C t~ ;~ Repair l/ Removal ~ Demotmon o~ Work ~[ ~ 4. Estimated Cost ~ ~. ~ Fee ~ ~ * ~ ' (To b~ng ~s application) 5. If dwelling, numb~ of dwelling ~its ~ [~ Number of dwelling units on each floor If ~ara~e, number of cars 6. If business, commercial or mixed occupancy, speci~ nature and extent of each t~e of use. ~ 7. Dimensionsofexistin~stmcmres, if any: Front (~' ~" Rear ~. Ch Depth ~ Height (~ ~t~ Number of Stories ~ T Dimensions of same struct~e w,t~ ~terations or additions: Front (~ ~" Rear ~ [ Depth ~ ,~ ~ tt Height (~ ~ ~ ,, Number of Stories [ ~ 9. Size of lot: Front ~ / Re~ ~ / Depth ~, (~ r ~tl~(qqfNameofFo~Owner ~/~ 10. Date of Purchase 11. Zone or use district in which premises are situated ~d,} & ~a( ff 12. Does proposed construction violate ~y zoning law, ordinance or regulation? YES NO ~' 13. Will lot be re-~aded? YES NO ~Will excess fill be removed ~om premises? YES NO 14. NamesofOwnerofpremises (7- &c~a<~ Address ~ rffo~ ~*g PhoneNo. ~g- Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet cfa tidal wetl~d or a ~eshwater wetland? *YES ~NO ~ · IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PE~ITS MAY ~EQU[RED. b. Is tMs propeay within 300 feet of a tidal wetl~d? * YES NO · IF YES, D.E.C. PE~ITS 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 l0 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OFF,-, (_.~'~&cY~:;?l,~ t~'t~ d~ ,,( being duly swom, d~osesandsa~sthat(s)heistheapplic~t (Name of individ~l si~ng contract) above named, (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 the manner set forth in the application filed therewith. Sworn to before me this IX'~'~' dayof Jo~7 200~ John M. Judge NOTARY PUBLIC. State of New No 01JU6059400 Oual f od In Suflotk Counb/ ~mm~ssion Exl~ res May 29, 20 ~~ignamre of Applicam Z N/o/~ sTEPHEN DUKE EVELYN B. DuKE bi 49'02'40" E 55.00' 2612' 0 " S 49'02'40" W 55.00' f,s.~. ~J SURVEY OF PROPERTY · SITUATED AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-142-02-19 SCALE 1" -20' NOVEMBER 22, 199-5 AREA = 1;5,726.24 sq. ff. 0.315 ac. CERTIFIED TO: ~HICAGO TITLE INSURANCE COMPANY CENTERBANK MORTGAGE COMPANY S~TATE OF NEW YORK MORTGAGE AGENCY ~OBERT $o WHITE '3 THE EXI~TANC£ OF RIGH~r OF WAYS AND/OR EASEMENTS OF I~CORD, IF ANY, NOT SHOWN AR[ NOT GUARANTEED. N.Y.S. Uc. fla. 49668 Joseph A. Ingegno Land Surveyor Title Surveys -- Subdivieiona -- Site Plaos - Construction Layout PHONE (516)727-2090 Fax (516)722-5095 OFI~ES Lo~TED AT 1,4NUNO ADDRES~ One Unio~ Square P.O. ~ox 1951 Aquebogue. New York 1 I g51 Rive~head, New York 11 gO 1 ~ ! M .g: x H ,,~;~ s~opu~J~fi gunH alqno(] ,~u!ls!x3 (~) I<----.~/~.ot ,~-~1 I I I I M .:/~-6~ x H .~z~-S~ JapeaH s,.9 x .: (:) ql!aa aaopu!M Ssel9 peu!e3$ Pallm, SUl M ,9 x H .Z,9 ~luO apls ~je~ suado - Jooo elqnoo ~up, spc3 ~oo1:1 a~,aJ3UO :,~ Pallm, SUt JgAO ~ (uo!leaal3 acS) xade u! pa~a~.ua3 mopu!~ 8up, uaauoN ~u Bs!x3 I T T