HomeMy WebLinkAbout31667-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31360
THIS CERTIFIES that the building ADDITION
Date: 12/29/05
Location of Property: 705 KNOLLWOOD LA MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 107 Block 6 Lot 7
Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 8, 2005 pursuant to which
Building Permit No. 31667-Z dated DECEMBER 9, 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 INSTALLATION OF HEAT TO AN EXISTING FINISHED PORCH ADDITION OF
EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CATHERINE E BARLEY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2082782 12/13/05
PLUMBERS CERTIFICATION DATED N/A
'—'-4 1, Z� -
ut rize Signature
Rev. 1/81
FormNo.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY '
This application must be filled in by typewriter or ink and submitted to the Building Depattmentwith the followit g:
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,
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
New Construction: Old or Pre-existing Building: (check one)
Location of Property:JKtbo
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section cJ lock -- 0,0 40 _ Lot
Subdivision __. _ Filed Map. _ _ Lot: _
Pennil. No: --' Date of Penn t./-1 � f� _ Applicant:__ uRw_ �c c 1�.. / ` ✓L�.
Health Dept.
Planning Board Approval:
Request for: Temporary Certificate _
Fee Submitted:
co -t- 3 3(o0
Underwriters Approval:
Final Certificate: _ (check one)
Applicant Signature
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET — NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
PETER EARLEY
16 N. IRVING ST.
RIDGEWOOD, NJ 07450
Located at 705 KNOLLWOOD DR. MATTITUCK, NY 11952
Application Number: 2082782
Section: Block: Lot:
CATHERINE EARLEY
705 KNOLLWOOD DR.
MATTITUCK, NY 11952
Certificate Number:
Building Permit:
2082782
BDC: ns11
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:
First Floor, Outside, Porch/Deck,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 13th Day of December, 2005.
Name QTY Rate Ratine Circuit Type
Miscellaneous
as built -1984 enclosed porch
Wiring and Devices
Outlet 3 0 Fixture
Fixture 3 0 Incandescent
Outlet 7 0 General Purpose
Receptacle 6 0 General Purpose
Switch 3 0 General Purpose
Paddle Fan 1 0
An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to
be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system.
seal
I of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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. 31667 Z Date DECEMBER 9, 2005
Permission is hereby granted to:
CATHERINE E EARLEY
PO BOX 1265
MATTITUCK,NY 11952
for :
INSTALLATION OF HEAT TO AN EXISTING FINISHED PORCH ADDITION AS
APPLIED FOR
at premises located at 705 KNOLLWOOD LA MATTITUCK
County Tax Map No. 473889 Section 107 Block 0006 Lot No. 007
pursuant to application dated DECEMBER 8, 2005 and approved by the
Building Inspector to expire on JUNE 9, 2007.
Fee $ 300.0
1
Authorized Signature
ORIGINAL
Rev. 5/8/02
Town of Southold
Building Department
P.O. Box 1179
Southold, NY 11971
December 9, 2005
Re: Earley Residence
705 Knollwood Lane
Mattituck, NY
To whom it may concern,
3i6(o -7
I have inspected the sun porch at the Early residence that was built in 1983. I am certifying to the best of my
ability that the existing sun porch meets the energy code that was in affect in 1983 when the original permit was issued.
The owner has told me the construction materials that were used during the period it was built. If you have any
questions please don't hesitate to call my office. Thank You
Sincerely,
Ronald Kuoppala A.I.A.
RONALD
KUOPPALA
A. I.
A.,
48
McKinley Street
Massapequa
Park,
NY 11762
A R C H I T E C T
Phone/Fax 516-797-8317
DEC -109-2005 02:19 PM RK ARCHITECTS 5167970317
.. ._ _ P.02
Town of Southold
Building Department
P.O. Box 1179
Southold, NY 11971
December 9, 2005
Re: Earley Residence
705 Knollwood Lane
Mattituck, NY
To whom it may concern,
I have inspected the sun porch at the Early residence that was built in 1983.1 am certifying to the best of my
ability that the existing sun porch meets the energy code that was in affect in 1983 when the original permit was issued.
The owner has told me the construction materials that were used during the period it was built. If you have any
questions please don't hesitate to call my office. Thank You
Sincerely,
Ronald Kuoppala A.I.A.
RONALD KUOPPALA A. I. A., ARCHITECT
49 McKinley Street Massapequa Park, NY 11762 Phone/Fax 516-797-8317
FIELD INSPECTION REPORT
DATE
COMMENTS
FOUNDATION (1ST)
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FOUNDATION (2ND)
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INSULATION PER N. Y.
STATE ENERGY CODE
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FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
SOUTHOLD, NY 11971
4 sets of Building Plans
TEL: (1631) 765-1802
Planning Board approval
FAX: (631) 765-9502
Survey
wtivw. riorthfork.net/Southold/ PERMIT NO.
Check
Septic Form
N.Y.S.D.E.C._
Lxamined20 AS
Trustees
Contact:
Approved 1 2Ji , 200S'
Mail to: �• � �� �d
Disapproved a/c
Phone :1 9=E"1 -')7_L_
Expiradon_____�L!J__, 20 (97_
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date AQ, , 2005
INSTRUCTIONS
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 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.
(Signa turreof applicant or name, if a corporation)
1'o ^4 La.
( din address of )ppli@fmt) Iii
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises in C_ 6v,' l to
(As on the tax roll
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.
latest deed)
Location of land on which proposed work will be
1 done: ^l. n/l
_ 705 nol\Wood 1�•
House Number Street Hamlet
County Tax Map No. 1000 Section �_�_Block Lot
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
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition OtherWork' j�� bGSG%dar
rc; d L&Aor (DTscription)
4. Estimated Cost Fee
I (To be paid on filing this application)
5. If dwelling, number of dwelling units l __Number of dwelling units on each flonr-
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front Rear
Heicaht Number of Stories
Depth
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 Q
9. Size of lot: Front Q d r Rear 54.90' 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? YES NO
13. Will lot be re -graded? YES NO Will excess fill be removed from premises? YES NO
14. Nantes of Owner of premises Address Phone No.
Nance of Architect Address Phone No
Name of Contractor Address
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
* 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:
CO TY OFSj
_ 41 _Ut"1V I "if ut n0 being duly swom, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
!L 1- G
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,
4> day of 20 of
Notary Public
BARBARA ANN RUDDER
Notary Public, State of New York
No. 4855805
Qualified in Suffolk County
Commission Expires April 14, 2W)a
Signature of Applicant
TO OUTSIDE POST LIGHT
S'-02"
EX IST INC -x F=LOOiR f'L- 4N
SCALE: 1/4" = 1'-0"
EXIST,
ASPHALT SHINGLE ROOF
EXIST.
WOOD FASCIA W/
ALUM. GUTTERS t LEADERS
EXIST, HOUSE EXIST,
WOOD SIDING
T.O. SLAB
GRADE
`� EXIST.
------------ FOUND. WALL FFTG.
--- L
1Zlr-*4T SIDE ELr=VATION
SCALE: 1/4" = I'-0"
I
I'-0"' ELE�,4TION
SCALE= I/4"
EXIST. ROOF CONSTRUCTION
EXIST. WALL CONSTRUCTION
GRADE
EXIST. FOUND,
SECTION "�-.4"
SCALE= 1/4" = I'-0"
EXIST,
ASPHALT SHINGLE ROOF
/EXIST- HOUSE FASCIA
EXIST,
WOOD FASCIA W/
ALUM -GUTTERS !LEADERS
EXIST.
WOOD SIDING
T.O. SLAB
� GRADE
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L FOUND. WALL 6 FTG.
EXIST.
ALUM. GUTTERS t LEADERS
EXIST -FIBERGLASS INSUL \t WOOD FASCIA
EXIST. CEIL. JOISTS w
CONT. SCREENED
6' W SOFFIT VENT
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F
EXIST- CONC. SLAB
EXIST.
ROOF VENT
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ASPHALT SHINGLE ROOF
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EXIST.
WOOD SID
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GRADE
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FOUND. WALL < FTG-— — — — — — — -
L----- -
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
L EST
EXIST- HOUSE
ALL CONSTRUCTION SHALL
NEWTHE REQUIREMENTS OF THE
CODES OF NEW YORK STATE.
APPROVED AS NOTED
3 /(
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FPF— 361._ SY
UNDliRMTERSCERTIFICATE
NOTIFY EUILo Dr
v- AT
755-1802 8b'! 0
THE
REQUIRED
FOLLn!'MG 'J IS°ECl'
1. FOUNDA`'�N -'iV
-" �,ED
FOR POURED Cr
2. ROUGH - FRAMI;
jMSING
S f D E V� T I ON 4 FINAL - CONS` ! MUST
SCALE= 1/4" - I'-0"
BE COMPLET� J.
ALL CONSTRUC W LL MEET THE
REQUIREMENT` -CODES OF NEW
YORK STATE. -SPONSIPLE FOR
DESIGN OR Q,�,a(RUCTION ERRORS,