Loading...
HomeMy WebLinkAbout30474-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31242 Date: 10/26/05 THIS CERTIFIES that the building ALTERATION Location of Property: 3480 CR 48 MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 141 Block 3 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 7, 2004 pursuant to which Building Permit No. 30474-Z dated JULY 12, 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 INTERIOR ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & VERA-JEAN BROWN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 202250 04/11/05 PLUMBERS CERTIFICATION DATED 09/29/05 GREENPORT PLUMB.&HEATING Authorized Signature Rev. 1/81 Form No.6 j TOWN OF SOUTHOLD Z 6 205 BUILDING DEPARTMENT TOWN HALL 765-1802 E _ 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, Swirmning 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, Coramercial$15.00 Date. New Construction: Old or Pre-existing Building:_ t/ (check one) Location of Property: e(S Sn)w � (.'>U3� 11A f rTt,Y jL_ House No. S' Street Hamlet Owner or Owners of Property: /2000Zr A I✓fflA'J OW F'f—W 4 Suffolk County Tax Map No 1000, Section / Block 0Lob2l Lot T Subdivision _Piled Map. _ Lot: Permit No. o Date ofPennit. Y//Z. o y-_ Applicant: / Awl &PQIRI Health Dept. Approval: ( Underwriters Approval: Planning Board Approval: /h Request for: Temporary Certificate / Final Certificate: - (check one) Fee Submitted: $ 1 Applicant Signature cin� 3I . �14, , cP cPill iffil INr1� rJ�cP cPrJrJ� cPrJrJrJr�rJ�PrJ rJ�r� rJrP D SBY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOAEAU OF ERD OFE �IcREUNDERWRITERS 5 ITY 40 FULTON STREET — NEW YORK, NY 10038 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 Q.C. ELECTRIC INC. ROBERT BROWN 5 5 P.O. BOX 518 11815 SOUND AVE. 5 LAUREL, NY 11948-0518, MATTITUCK, NY 11952 c5 5 Located at 11815 SOUND AVE. MATTITUCK, NY 11952 5 c Application Number: 2022250 Certificate Number: 2022250 5 Section: Block: Lot: Building Permit: BDC: ns11 5 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: 5 First Floor, Second Floor, 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 �j promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 11th Day of April, 2005. 5 Name aTY Rate Rating Circuit Type 5 SMiscellaneous 5 second floor bathroom reno. Alarm and Emergency Equipment Sensor 1 0 Carbon Monoxide �5 5 Sensor 2 0 Smoke 5 Appliances and Accwsar les Exhaust Fan 1 0 F.A.P. Wiring and Devices 555 Outlet 11 0 Fixture Fixture 10 0 Incandescent Fixture 1 0 Flourescent 55' Outlet 11 0 General Purpose f Receptacle 5 0 General Purpose �i7 5 Switch 11 0 General Purpose l5 5 Receptacle 1 0 20 amp Laundry 5 Receptacle 1 0 30 amp Dryer Receptacle 2 0 GFCI seal 5 5 1 of l CL+++ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. S 5 5 • MIN cPrJcP o o��gUFfO[,�oo y Z Town Hall,53095 Main Road Oy �� Fax(631)765-9502 P.O.Box 1179 �ol �a0 Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: F � os� Building Permit No. Owner: /2o& (Please print) Plumber: (Please print) T />i�^�%�� I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day oof� Yx-h 20 Mak 1 2007 Notary Public, A-S kT(D lk County so Town Hall,53095 Main Road F�(631)765-9502 P.O. Box 1179 CIO -*a- Telephone(631)765-1802 Southold,New York 11971-0959 COUNTI, BUILDING DEPARTMENT TOW'N OF SOUTHOLD August 4, 2005 MR. ROBERT BROWN 11815 SOUND AVE. MATTITUCK, N.Y. 11952 To Whom It May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Electrical Certificate on file. v--' The Check is not on file. —$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being Tlf-- issued after April 1, 1984.) BUILDING PERMIT#30474-Z (ALTERATION) 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. 30474 Z Date JULY 12 , 2004 Permission is hereby granted to : ROBERT BROWN 11815 SOUND AVE MATTITUCK,NY 11952 for INTERIOR ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 3480 CR 48 MATTITUCK County Tax Map No. 473889 Section 141 Block 0003 Lot No. 015 pursuant to application dated JULY 7, 2004 and approved by the Building Inspector to expire on JANUARY 12 , 2006 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 FIELD INSPECTION REPORT DATE COMMENTS u1 ..c FOUNDATION(1ST) q4 414J a ---------------------------------- C FOUNDATION(2ND) +K7 �• x Wo ' s O H ROUGH FRAMING& PLUMBING y L INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS I j 10 Lf C • Z A' tl S z r � x ro �3 3o � ;7� z 76S-1802 ,44 latvv- BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE �� �� �� INSPECTOR �/i� 3© yam- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ " ROUGH PLBG. [ FRAMING 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE&CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: /"- - -C__ DATE �� fl INSPECTOR / ao /5% -3 -1sTOWN OF SOUTHOLD PROPERTY RECORD CARD o OWNER STREET VILLAGE DIST., SUB. LOT FORMER OWNER N E ChQ�? ACR./ S / W TYPE OF BUILDING DAWDtd9K / s , .. �. 13vGovicNfw/ 02� RR«ei� ES. 2a—O SEAS. VL. FARM COMM. CB. MICS. Mkt. Value RVQ iFnio✓P c LAND IMP. TOTAL DATE REMARKS �: oQ- D 7 !! Z ! 6 Oc o S ©. a Jv 7/s/�3 Ss-G� tS'6 D i a �a e wS /C i rb C T a 3 a (n-60Cv cm- 2-v-19s- - - 4 -4- Aran el v� l`o 2-0 0 loj- UaDbv - M)y-) *n�/0f L)oa 17 IrCLj8Pt a' 33 cK oe,rig,63 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD s` ��! /ve -p - Z,6 / t� Meadowland DEPTH House Plot BULKHEAD Total DOCK Y ' ; .� : ��C®:':NOON::■:®®:®■�C■■ NOON■ C■.■......■..®....■■■■_� NOSES EMEME NOON■■■==='====�F�■■■■N■■ ■■NE■ NOOSE ■■■■NE■■■N■■E■N�■©�■■■■■■■■NEN - , _ ■■■ NOON®NOON■®li■■■■■■■■■■■■■ i�■oi�■ice®�■���■��®■MENEMN■■ TOWN OF SOUT$OLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMEN r 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 PERMIT NO. 3 O q7�(-t�r Check Septic Form N.Y.S.D.E.C. Examined,207 % Contact:Trustees Approved_ '//�j ,20D Mail to: Disapproved a/c �T Phone: Expiration � 1'' ,20__,�2(, �C — Building Inspector PLICATION FOR BUILDING PERMIT Date 20q ,- 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 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. l�—tea Siig�nature of applicant otrgname, ,if a corporation) (m� ,S 704 4e - 1 i lf�JG�[ IV I i 1 ls. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Gt�tnGv' Name of owner of premises 1..� – Jeal+ . ilm vr• (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: . r 1�(S e' B✓ml- PCNL ' WI LfUc� House Number Street ''/ Hamlet County Tax Map No. 1000 Section �-(7 Block vo03 % Ldt O� Subdivision Filed Map 1 0. "" �•� (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy G, 1� � , b. Intended use and occupancy. 5 -r-•P 3. Nature of work(check which applicable):New Building Addition Alteration ✓ Repair Removal Demolition Other Work (Description) 4. Estimated Cost 20C.oov' 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 - r Rear :3$ Depth 3 S' Height !:�-3 o Number of Stories 2 +&V cc, Dimensions of same structure with alterations or additions: Front fro Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front 1t4 Rea`r~ Depth Height ,y Number of Stories 9. Size of lot: Front_ J 1 Rear H g Depth A7 3 J10. Date of Purchase V_A G?A&1D Name of Former Owner 11. Zone or use district in which premises are situated 1C1-'S - 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO 13. Will lot be r(-graded?YES_NO "Will excess fill be removed from premises? YES_NO 14. Names of Owner of rermses4K,& &4.-,IN.Atro Mdress Phone No. ?-'N- 26coT- Name of Architect 1s Address Phone No q71-9 7S L_ Nameof Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NOy� * 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 O i being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing 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 day of 20 Pu c Signature of Applicant JOYCE A.STEVENS NOTARY PUBLIC,STATE OF NEW YORK OUALIFIEO IN SUFFOLK COUNTY COMMISSION EXPIRES NOVEMBER 3,20W Applicant/ Date, Owners Naive: V7 ����n--- Reviewed: 7 Architect/ Date Engineer: Submitted: 71714 SCTM #: District: 1.000 Section: _ 131ock:31 Lot: 1'�F- _ project Subdivision Location: ,� ( - � ---- — Name: Sin&le& separate Required !`J certification: Yes f No �C,�d�1.' Req. Rey. Zoning 1)islrict: /'�/ ` (Lot size: _ Acwal: 6 I iutwscJ 1 1 (Lot CUVCrB C Req. Req J(=roni Yard Proposed: J [Side Yard Req Proposed: J [Rear Yard Proposed J Project Description: pie AGENCh1 t TS Lexi r n,t BES2UIRED FOR REVIEW N.A. NO YESm WeT Suffolk County Health Dept. New York State D. R C. ✓ Town Trustees Town Zoning Board approval: Town Planning Board approval: / !. Flood Plane Elevation?79 € Flood Zone: Notes: ' 1 2 3 4 5 G 7 8 9 10 II 12 13 14 15 1G 17 155UE5/UV1510145 - � K t. NEW SECOND FLOOR 5ATHROOM5 rel 3' VENT • LAVAT Y LAV TORY J SHOWE TI TOILET ROWER TUB 2nd FLOOR, PON • • I et FLOOR. . • \ /T Ay i�1ISYf T05EWE SYSTEM L. EX15TING HIXl E RAP DRAIN a PLUMBING RISGER � rEN ' NOT TO SCALE MEN r_�y+ �1 004 ALL RIGHHT5 RESERVED 6 1/2" THESE PLANS ARE AN INSTRUMENT OF • 5ERVICE AND ARE THE PROPERTY OF THE ARCHITECT INFRINGEMENT5 WILL BE PROSECUTED, Li Li �'GF - 26 -` T 1 . ' NEW G� �� I I �j lS n(G cswlw� _ HANDRAIL — -T- g pkv _ - - � - fin)Ph(LTIf I[ Cp 4D �.4 � P FLOOR 5 r � r REMOVE I x STRUCTURE OV - 5H VE5 1 Qa '- 0� 2"Y (° D2 EXISTING 'HIDDE ' STAIRS rt u ' s-i 2'lfyn gtJOS,e M REM VE PLU 31 NG OVER 2GGa '`, �D< © �' w� EXIS ING STA DOWN yl /n1P WA5HE LSA FiICiE (AI �68 QCOII){ INS�L. • { 466 t a • CIENT/OWNER i DRYER J Z 66a vz^ 1/z• r •' BROWN RESIDENCE 4,), 4D6 ROVED AS NOTED SOUND AVENUE D MATTITUCK, N.Y. DATE: B.P.# .90,f � Z FEE: BY: NOTI UILDING DEPARTMENT AT 765.76 6A TO 4P FOR THE L Ll FOLLO 11 IG INSPECTIONS: 1. FO CATION - TWO REQUIRED VA FO P URED CONCRETE PROJECT TITLE 2. RO G - FRAMING 8 PLUMBING 9. INS L TION 4. FIN L CONSTRUCTION MUST rA BE APLETE FOR C.O. (lam ALL TRUCTION SHALL MEET THE �HMd®'`tl14TIW/FICA TION r REOU AENTSOFTHE CODES OFNEWr , „dFENTBEFORE YORK ATE. NOT RESPONSIBLE FOR CEF�`i� 'I(;,� c OF OCCUPANCY DESK R CONSTRUCTION ERRORS. /^all DRAWINGTSGPPLY, '':I1--7 ; CANNOT EXCEED u'1 a C.,F 1 sb LEAD. - OCCUPANC F— I1 NDFTIaUSE IS UNL, PLANS AND ELEVATIONS FASDN, "�ATHOUT C CATE UNLESS ACTINO UNDER ' DIRECTION OFA 4CENA�S�1pQfy11CC (� ARCHITECT.TO ITEM ON THIS DMWwAa' VF OCCUPA ,� DATE�', 5CALE ANYWAY-ANYAUTIOROPD ALTERATION MUST BE 1IW' = I'-o^ NOTED,SEALED,AND DESCRI13ED INACWRDANN ISSUE WITH THE LAW. JULY 06, 2004 SECOND FLOOR EXISTING SECOND FLOOR PROPOSEDp\5<EPZOI.BRO UNDERWRITER I A*AwiNG NO, EXISTING TO REMAIN EXCEPT AS NOTED EXISTING TO REMAIN EXCEPT AS NOTED ¢� REDUR ALLPL MME3ING AT] G SEFOhE 6,NIPc ' NG 183AN yO Jt oP N� ALL CGNSTRUC I LL H JUL 72004 EETTHE REQUIRE FTHE CODES'OFNEW' e. NO. �+ 0000