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HomeMy WebLinkAbout30973-ZFORM NO. 4 TOWN OF SOL~fHOLD BUILDING DEP~uRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34847 I~ate: 02/24/11 THIS CERTIFIES that the building D/DDITIONS/ALTERATIONS Location of Property: 3020 NEW SUFFOLK AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 12 Lot 16.1 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 1, 2005 pursuant to which Building Permit No. 30973-Z dated FEBRUARY 22, 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 ALTERATIONS AND ADDITIONS, INCLUDING DECK & COVERED DECK WITH BREEZEWAY, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS C/O REPLACES C0Z-31631, ISSUED 6/27/06. · ~ne certificate is issued to GA/~Y H ROSE of the aforesaid building. ( OWNER ) SUFFOi~K CO~%'~Y DEP~/~T~T OF ~TH APPRO%rAL ELRdLi-KICAL <~TIFICATH NO. PL~ C~KTIFICATION Da'r~u3 06 / 08 / 06 N/A 6335 09/23/05 MATTITUCK PLUMBING & HEAT Signature Rev. 1/81 Form No. 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 Department with the following: A. For new building or new use: 1. Final survey °f pr°perry with accurate location of all buildings, p.roperty lines, streets, and unusual natural or topographic features. 2. Final APpr°val from Health Dept. of water supply and sewerage.disposal (S_9 form). 3. -Approval of electrical iustallation from Board o f Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commex¢ial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Complianca from architect or engineer responsible for the building. 6..Submit PI. ~anning Board Approval of completed site plan requirements. B; Fo~ existing b~ildings (prior to April 9, 1957) non--conforming uses, or buildings and "pre-existing" land uses: 1. Accui'ate survey 0f pr0perty 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. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing ~o the applicant. C. Fees 1. Certificate of Occupancy - New dwetliug $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.(}0. 2. Certificate of 0ccupancy 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 Cousmction: L°%tion of Property: Date. Old or Pre-existing Buildin~ House No. Owner °r Ownem 0f Property: ~,~3 ~,' - Suffolk County Tax Map No 1000, Section $ubdixd:iion )ateof e mit. Health Dept. Approval: Planning Board Appreval: Street (check one) Hamlet -Blo k /& lC, i Filed Map. Lot: Applicant: Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ ~.~ ["), ~ Final Certificate: (check one) FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31631 Date: 06/27/06 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 1020 NEW SUFFOLK AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 12 Lot 16.1 subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 1, 2005 pursuant to wh/ch Building Permit No. 30973-Z dated FEBRUARY 22, 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5583 DATED 12/2/04. The certificate is issued to GARY H ROSE of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF ~RALTH APPROVAL EI~-I'KICAL CERTIFICATE NO. PLUMBEP~ CERTIFICATION DA'r~D 06/08/06 N/A 6335 09/23/05 MATTITUCK PLUMBING & HEAT Authorized Signature Rev. 1/81 l~orm No, TOWN OF llUILDING Dlg~ARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY JUN I G Thin application mt~t be filled m by typewriter or nk and subtmtted to the Building Department wiih the ~oll6W~!)~2~_'...___J A. t~'or t~ew building or new u~e: 1. Final survey of property with a~urate location of all buildings, property Iines, slxe~ts, and unu~tml natural or . topographic features. . 2. Final Approval from Henlth Dept. of water supply and ~w~ragc-disposal (S-9 fern0, 3. Approv.~l of e]~ttioal in~tallatJon from I~oard nf Fim Underwfit~rs, 4. Swore. stat~menl from plumber corlifying that the solder used in sys!em con~ains leas than 2/10 of 1% Icad. C~mmemial b~i[~ding~ ii~h~strial bui~di~g~ mu~p]e r~iden~¢s and similar bui~ding~ and insta~ati~n~ a cetiificate of Code Compliance ii.om arohii~ct or e~nglneo- responsible for the building. 0, Subi.nit Plannin$13nan! ~,ppl'ova[ of t~'onlpiel'eg site plan requirements. For, ex/sting buildings (prior to April 9, 1957) non-conforming uses, or builffings and "pr~exisling- land uses: ... A~at~ su~ey ofprope~y showing a[l prop~'ty lines, a~ts, buil&ng and unusual nat~al or topo~phic f~tur~. 2. A prop~ly ~mplci~ application and consaa in it~)ect si~ by d~ applicant. Ifa C~fiost, of O~up~ey is d*M~, tho Building Msp~tor $lmll ,state the reasons thercfor in writing to the applie~t. C~fi~at~ of Oceup~cy. New dwedmg $,5.00, Ad,hens to dw,lhng $25.00, Mtm'ations to dw~h~ $2L00, Sw'i~ng pool $25.00, _&c~s~i~ buildiug $25.00, Additions to a*~s~6ry bulldog $25.00, BuaMo$a~ $50.00. 2. C~ficate of Occupancy on Fre-exiating Building · $100.~ C~yofCenifi~t, of Oceupancy- $.25 Updat~ C~tiificate ofOc~paney - $50_00 T~mpormy Certifioate of Occupancy - Residcmial $15.00, Cmm~eial $15.00 (ch~k one) 5laffc..l.k Comity Tax Map No 1000, Section [ t q ~nbdD,'iaioll Dept, Approvah ........................ Undel~ritem Approvah Piat~ng Board Approval; ............................... ;l~ues~ fbi: 3.'mporay Cel~ificate ................ Fill Cerlifioat~: / ,Submitted: $. ~ ................. mook___.Ck0_12_~.~___ t,ot i5 ] 0.0o I Filed Map. Lot: (chock one) ~__~plicant $~gnaturc Hamlet Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street * Center Moriches, New York 11934 * Tel: 631-878-3500 * Fax: 631-878-3764 Application: 6335 Date: 9/23/05 Issued to: Rose Address: 1020 New Suffolk Ave Village: Mattituck By: First Class Electric was examined and approved up to the above date and was in compliance with the NEC ,NtJci-~1 1st Root r'2'l Residential r~-'l Fool Bet Ga'age Basementf'~''l 2nd floor ~al Hot Tub gddition Fffi Smoke Switches Receptacles Fixtures G.F.I. Microwave Detectors 34 25 19 6 1 8 Oven Carbon Fans Bishwasher Washer/Amps Bryer/Amps Range/Amps Monoxide 3-paddle/I-Ex 1 I 1 1 Furnace Oil Gas Heat Zones Whirlpool Bell Transformers {ear Addition & Meter Amps Phase Motors ~arage Wiring 1 200A UG 1 :)ther Equipment: 1-StackableWasher/Dryer 2-12ftTrack l-Sub Panel ~Out,Res This certificate must not be altered in any manner Tov, n Hall, 53095 Main Road PO Box 1179 Somhold, New York 11971-0959 Fax (631) 765.9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Building Permit No. '~ ~ ")--~ ~ (Please pnnt) (Please p6nt)' ~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 7~ / ~ (Plu~ignature) day or ~j_~'",~,~ , 2o2t,, Notary Public,. ~ County /-' 6'0 ~g '9~..l'*p,I sel!dx:l uo!ss!tuu~oo AIR ~unoO ~tlollnS ul Pe§!l*nO g~Z~.t~091)t !,0# uogvJta!fi,3~ ~gNIN :ISIN~tQ DENISE KiNG Notary PubliO, State of New ¥o~ Registration #01KI6041757 Qualified in Suffolk County My Commission Expires May 15, ~ 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. 30973 Z Date FEBRUARY 22, 2005 Permission is hereby granted to: GARY H ROSE MATTITUCK,NY 11952 for : ~ ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER ZBA DECISION 5538 at premises located at County Tax Map No. 473889 Section 114 pursuant to application dated FEBRUARY Building Inspector to e~ire on AUGUST Fee $ 504.60 1020 NEW SUFFOLK AVE MATTITUCK Block 0012 Lot No. 016. 001 1, 2005 and approved by the 22, 2006. ORIGINAL Rev. 5/8/02 APPEALS BOARD MEMBERS ,Ruth D. Oliva, Chairwoman Gerard P. Goehringer Lydia A. Tortora Vincent Orlando James Dinizio, Jr. http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Southold Town Hall 53095 Main [load EO. Box 1179 Southold, NY 11971-0959 Tel. (631) 765-1809 Fax (631) 765-9064 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF DECEMBER 2, 2004 ZBA Ref. 5583 - GARY ROSE Property Location: 1020 New Suffolk Avenue, Mattituck CTM 114-12-16.1 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicant's 37,477 sq. ft. parcel has 100 feet along New Suffolk Avenue and 319.59 feet along the east side property line in Mattituck. The property is improved with a one-story residence with deck and detached garage as shown on the June 28, 2004 survey prepared by Stanley J. Isaksen, Jr. BASIS OF APPLICATION: Building Department's July 14, 2004 Notice of Disapproval, citing Sections 100-242A and 100-244, concerning applicant's request for a building permit to construct an addition to the existing dwelling and to add breezeway, connecting the existing accessory garage. After construction, the building will be setback at less than 40 feet from the front lot line, less than 15 feet on a single side yard, and less than 35 feet for both side yards. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on October 21, 2004 at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: The applicant wishes to construct an addition to the existing dwelling, with a breezeway over a new deck, as shown on the August 14, 2004 plans, prepared by David H. Sherwood, Architect, and sketched-in survey stamped by ZBA August 23, 2004 date. The dwelling is 19.1 feet from the front lot line and 6.2 feet from the westerly side line. The garage is existing at 18.8 feet from the front line and 5.1 feet from the easterly side line. After the new construction, the principal building (both buildings connected into one) will have a combined side yard area of 11.3 feet. The existing setbacks to the dwelling and garage will remain unchanged, and the addition is proposed at a distance greater than 40 feet from the front property line. Page 2 - December 2, 2004 ZB Ref. 5583 - Gary Rose CTM Id: 114-12-16.1 REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The variances requested will enable the applicant to connect a nonconforming detached garage via a breezeway to the principal dwelling, which will be enlarged to accommodate a new bedroom, den and bath, The new construction will not alter the footprint of the existing garage, which wii~ become part of the principal dwelling. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than variances. The setbacks of the existing detached garage will automatically become nonconforming when it is attached to the principal dwelling. The applicant has no other practical means to enlarge the dwelling without variances. 3. The relief granted herein is not substantial because there will be no physical change in the footprint of the nonconforming setbacks of the existing buildings. 4. The alleged difficulty has not been self-created and is due to applicant's desire to reclassify the garage as part of the principal dwelling. 5. No evidence has been submitted to suggest that the relief granted will have an adverse impact on physical or environmental conditions in the neighborhood. 6. Grant of the requested relief is the minimum action necessary and adequate to enable ' the applicant to enjoy the benefit of a new addition, while preserving and protecting the character of the neighborhood and the heath, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Tortora, seconded by Member Goehringer, and duly carried, to GRANT the variance as applied for, as shown on the August 14, 2004 plans prepared by David H, Sherwood, Architect, and sketched-in survey stamped by ZBA August 23, 2004. This action does not authorize or condone any current or future use, setback or other feature of the age 3 - December 2, 2004 ZB Ref. 5583 - Gary Rose CTM Id: 114-12-16.1 subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Oliva Vote of the Board: Ayes: Members ~.(Chairwoman), Goehringer, Tortora, and Dinizio. (Member Orlando was absent, out of state.) Tbl-s P.~solution d).~t,~(~,pted .(4-0). Ruth D. Oliv.a, Chairwoman 12/6/04 · Approved f~ff~ Filing New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631)444-0365 · FAX: (631)444-0360 Website: www.dec.state.ny.us Erin M. Crotty Commissioner Letter of Non-Jurisdiction - Freshwater Wetlands Act Januaw25 2005 Gary H. Rose 1020 New Suffolk Ave Mattituck, NY 11952 Dear: Mr. Rose: Re: Rose Propedy 1020 New Suffolk Avenue, Mattituck 1-4738-03385/00001 Based on the information you have submitted, including the survey prepared by Stanley J. Isaksen, Jr., dated June 28 2004 and last revised November 23 2004, the New York State Department of Environmental Conservation has determined that your proposed project to expand the single family dwelling on the parcel designated SCTM No. 1000- 114-12-16.1 is more than 100 feet from regulated freshwater wetlands. Therefore, no permit is required under the Freshwater Wetlands Act (Article 24 of the Environmental Conservation Law). Be advised, that all construction, clearing, and/or ground disturbance must remain more than 100 feet from the freshwater wetland boundary. In addition, any additional work, or modification to the project as described, may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Sincerely, George W. Hammarth Deputy Permit Administrator cc: NYSDEC Bureau of Habitat DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB K. JAVITS FEDERAL BUILDING NEW YORK, N,Y. 10278,-0090 Eastem Pexmits Section SUBJECT: Joint Application with New York State Department of Environmental Conservation 1020 New Suffolk Ave, Mattituck, NY Gary H. Rose 1020 New Suffolk Mattimck, 'NY 11952 Dear. Mr. Rose We have recently received a copy of the Joint Application for Permit you filed with the New York State Department of Environmental Conservation (NYSDEC). Please be advised we have reviewed the Joint Application, and based solely upon the information provided, it appears that a Department of the Army permit is not required for your proposal. The Department of the Army regulates construction activities in navigable waterways and discharges of dredged or fill material into waters of the United States, including inland and coastal wetlands. If your proposal would involve such work, and has not been portrayed as such in your Joint Application, you should contact this office immediately so that a project~specific determination can be made as to whether a Department of the Army permit will be required. Arty inquires should be directed to the Regulator-of-the-Day at 212-264-6731. Sincerely, Michael G. Vissichelli Acting Chief, Eastern Permits Section DEC Application No.: 1-4738-03385/00001 07/13/2005 13:21 FAX 6317254044 Permit Number REScheck Compliance Certificate 2000 IECC KEScheckSofiwaro Version 3.6 Rele~,~ 1 Data filensme: CAProgram F/les\Check~RF-Sckeck\GaryKose,rck Checked By/Dare PRO]BCT 'I'll'DE: Renovations and Addtitions to the Rose Residence CITY: Mattituck STATB: New York HDD: 5331 CONSTRUCTION TYPE: Single Family WINDOW / WALL RATIO: 0,18 DATE: 07/13/05 DATE OF PLANS: August 15, 2004 PROJECT DESCKIPTION: Master Bedroom, Ba~h ami Sm~y Add/don to Exi~a,,g Ho~e Kitchan and Dining Room Altotation~ to ~XiS~a~ D E S IOi',IEieJCO NTRACTOR: David H. £he~ ~ood, A.I.A. ~rchitect Post Offic~ Bc'x ?,681 Sag Harbor, New York 11963 COMPLIANCE: Passes Maximum UA - 273 Your Home UA = 266 2.6% Better Than Code (UA) ~ross Olazll~ Area o~ Cavity ConL Or Door P~meter ~ R-Value U-Factor UA Ceiling 1: Flit Ceiling or Schsor Tnm~ Ceiling 2: fJa'~,-~lral Ceiling (no auic) '/?5 Wall 1: Wow/F:ame, 16" o.c. 1335 Window 1: ~Vcod Frame:Double Pane with Low-E 132 Door 1: Glass 110 Floor 1: All-Wood Joist/Tn~s:Over Unconditioned Space 1104 21.0 0.0 '. 23 21.0 0.0 37 13.0 0.0 90 0.330 44 0,330 36 30.0 0~0 36 COMPLIANCE STATEMBNT: Thc ptoposcd building design desctibcd hem is comi~m with thc bufldi~ plans, specifications, and other calculatior." submitted with thc pcnmt application, Thc proposed buildtllg has b~en designed meet the 2000 IECC requlrcmcnt~ in ~ checkVersion 3.6 l~lcase 1 (formerly MBCchecl) and to comply with the mandatov/requizernents listed in the RI~5 checkIms'peetiou Checklist. 07/13/2005 13:21 F~X 8317254044 DH$&ROHITEOT ~001/002 David H. Sherwood Post O~ice Box 1~81 Sag Harbor, New York 11963 July 13, 2005 Town Of Southold Building Depamnent $3095 Main Road Southold, New York 11971 Aun: Damon Re: Rose Residence SCTM~1000-114-12-016.1 Permit~30973 Dear Damon, Following please fred ~ copy of the revised RBSCHECK compliance showing the actual insulation vahzcs that tho inst~llers we~ ablc ~o fit on-sil~. No~e lttat th~ wails and ccilin~s are both R-21, not R-19 and R-30 as originally specified. As you can see, this still meets the code requirements. Please fccl fi'cc to ~ive me a call if you have any questions ar need any additional reformation. Cc: Gary Rose Albert J. Krupski, President ...~--~J~ames King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson 53095 Route 25 ''' ~ P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 12, 2004 Mr. Gary Rose 1020 New Suffolk Ave. Mattituck, NY 11952 RE: 1020 NEW SUFFOLK AVE., MATTITUCK SCTM#114-12,16.1 Dear Mr. Rose: The Southold Town Board of Trustees reviewed the survey prepared by Stanley J. Isaksen, Jr. last revised June 28, 2004 and determined the proposed renovatiOn to the existing dwelling to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code. Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the Coastal Erosion Hazard Area (Chapter 37) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without s permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. However, any activity within 100' of a Wetland line or seaward of the Coastal Erosion Hazard Area would require permits from this office. This determination is not a determination from any other agency. /If you have any further questions, please do not hesitate to call, Sincerely, Board of Trustees AJK:lms TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING [~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [~x~INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ~FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [, ] FIRE SAFETY INSPECTION DATE 765-18O2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]~NDATION 2ND [ ] INSULATION / [~/] FRAMING [ ] FINAL FIREPLACE & CHIMNEY ~'~EMARKS: ~/~/~ ] FIRE SAFETY INSPECTION DATE INSPECTOR ~o77~ ~- 765-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST [ ~ FOUNDATION 2ND [ [ ] FRAMING [ ] ROUGH PLBG. ] INSULATION ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE /'~ ~7'- ~-~-'-- INSPECTOR TOWN OF SOUTHOLD ~UILDING DEPT. ?~-¶ 8~ INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE lO- ~ -- 05 __ INSPECTOR COMMENTS FIELD INSPECTION REPORT DATE l FOUNDATION (1ST) .....................................~.~-. ~,~- -~ .o .~..r ~ ~ FOUNDATION (2ND) ~~ ~ ~~~~g PLUMB~G . ~SULATION PER N. Y. STATE ENERGY CODE I~.o ~ , ., ~ ~DITION~ COMMENTS TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET /(~'~ O VILLAGE DIST, SUB. LOT FORME~R OWNER ~ /~z.c~._ E ACR. W ~PE OF BUILDING ~ND ' IMP. TOTAL DATE R~RKS ~7) ~0o ~ 7~3 ~ ~//~/?~ ~(~/7~ ~oL3 .ooo ~. ~'~ELI ~ ~o~' _~ -. ~o AGE BUILDING CONDI~ON N~ NOR~L BELOW ABOVE FA~ Acre Value Per ~Value Ac re Tillable FRONTAGE ON WATER W~lond FRONTAGE ON ROAD /O 0 ' ~ ~ .~ ~ : ~ ~ Meadowlond DEPTH House Plot ' BULKH~D Total D~K COLOR '~a'~ ~/' TRIM uu ~ ~ -r ~" M. Bldg. Extension Extension Extension Porch Breezeway C~roge Totol 3,00 Foundation Basement Ext. Walls Fire Place ,~7~ ' Type Roof /, C~ Recreation Room Dormer -B~th Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floor Driveway /.4)/q i' ~Jnette p / ,,,' 4- · TOWN OF SOUTHOLD BU!LDING~DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. north fo rk. net/Southold/ Examined Approved Disapproved a/c Expiration / PERMIT NO. -- Building BUILD1NG PERMIT APPLICATION CHECKLIST Do you have or neq~ thc following, before applying? Board of Health 4 sets of Building Plans ~ Planning Board approval Check v/ Septic Form" Trustees Contact: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ' N3 I 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 applicmR. ,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 lather regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extL~nsion of the permit for an addition six months. Thereal~er, a new permit shall be required. APPLICATION 1S HEREBY MADE to the Building Department for the issuance ofa Bui~ing 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. i~a~tur of applicant or name, i~ a corporation) (Maili~§ lddres$ of ~ppli¢~t) State whether applicant is own.er, lessee, agent, architect, engineer, general contractor, clccirician, plumber or builder Name of owner orpremises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate Electricians ~icense o. Other Trades License No. tx 1. Location of land on which proposed~work will be done: . House Number Street Hamlet County Tax Map No. 1000 Section [ ~ ~ Block I ~ Subdivision Filed Map No. .~Lot (Name) a Lot 016' I 2. State existing use and occupancy of premises and intended use and occupancy of prol~sed construction: a. Existing use und occupancy ~-,~,'1~ ~1~'~, b. Intended use and occupancy ~l~l~s/ ~[~VI. t ~ ~ ~'~tl~. 3. Nature of work (check which applicable): New Building Addition ~ Alteration Repair Removal Demolition Other Work :. (Description) 4. EstimatedCostq~/(~l~t OO~ Fee (To be paid on:hling this gpplication) 5. If dwelling, number of dwelling units I Number of dwelling units on each flo~r If flarage, number of ears 6. If business, commercial or mixed occupancy, specify nature and extent of each type of. ilse. 7. Dimensions of existing structures, if any: Front_ ~'~ Rear Height I~ '~'* Number of Stories Dimensions of sam~ structure with alterations or additions: Front a~ i. Rear '4~ Depth ~ Height {~.~,~ Number of Stories I ' 8. Dimensions o f entire new construction: Front Rear .Depth Height Number of Stories 9. Size oflot: Front 10~t Rear 1~51 Depth ' lq' ' 10, Date of Purchase 16t 7~ Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate uny zoning law, ordinance or regulation? YES ~ NO__ 13. Will lot be re-graded? YES NO v/ Will excess fill be removed from premises? :YES 14. NamesofOwner ofpremises~,~ ~;:~ost:~ Address IOZO/x/07-~ $O/~7~Ph~neNo. Name of Architect ,l~ll~d~l~ ,~c~t'~ICl~ Addrass ~}~-I~-~---v I~'l~hone No Name of Contractor "'To 'Be 3~'l'~0t~,d*}~ Address " ' ~hone No. 15 a. ls this property within 100 feet ora tidal wetland or a freshwater wetland? *YES v~ .. NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY B~ REQUIRED: b. Is this property within 300 feet of a tidal wetland? * YES NO g .... * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lin~s) 17. If elevation at uny point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ~'~a t~fo~K ~ing duly sworn, ~poses ~d says ~t Is)he is ~e applic~t ~e of individu~ si~g ~n~act) above n~ed, (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 mmmer set forth in the application filed therewith. Sworn to before me this ~,~J 's-T day of ,,.T',4 ~/t~.~ y 20 O,ff' Notary Public ~/ ature ~f A~!icant NEW SUFFOLK AVENUE CONC T1£=277.5~' 'N 88'29'00"E 100.00' MON SURVEY OF DESCRIBED PROPER-F'F SITUATE MATFITUCK, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: GARY H. ROSE FOUND O~ ONE STORY ~ RESIDENCE 6.2'- DRIVEWAY TM# 1000-114 12-015.? GUARANTEED TO: GARY H, ROSE N/F DONLIN CONOR~I'[ FOUNDATION (£XT[FqOR ONLY) ~ SEPTIE o.5'.., THE NYS FRESHWATER BOUNDARY IS .' EQUAL TO WETLAND LINE SHOWN ON .' THE SURVEY PREPARED BY STANLEY." ISAKSEN, DATED 6/28/04 AND .3 ADDITIONAL FLAGS AS DEL- INIATED (FLAGGED) BY r. MARSH ON 11/9/04, © CONC MON 88"'5.9'50"W 45.65' N 88'39'30"E 65.00' CONC . · "WE~ANDS DEUNEAT~ON" F~ACCED .' BY N.Y.S.D.E.C. (5) )0 N/F FOX POND t / N/F FELLER 2. 25 APR 05 LOCATE POURED CONC FOUNDATION, SANITARY, ?. 2,3 NOV 04 ADD DEC STATEMENT, POINTS FLAGGED, 100' FROM WETLANDS LINE, SURVEYED: 28 JUNE 2004 SCALE 1"= AREA = 57,477,04 OR 0,860 ACRES SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NEW SUFFOLK. N.Y. ? 1956 - ~ 2s~o~-- NOTIFY EUILDING 765-1802 8AM TO 4RM FOR THE FOLLOWIN~ iNSPECTIONS; 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ' APPROVEDASNOTED ' P' 2. ROUGH - FRAMING & PLUMBING , 3. INSULATION ¢,¢~ RA~-'TE~ / P,~.T~ / S'J~UD CO~CT~O~ 4, FINAL- CON~~,~i~Af F~' ' BE COMPLETE ~.~ ......... ~, ' ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF ~HE CODES OF NEW YORK STATE, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. .~ PoRcH [BEAM TO POST ANCHOR' ~,.,~ NOr .O~CALE , COMPLY WITH ALL,CODES OF NEW YORK STATE ' ' ' AS REQUIRED AND coNDITIONS ¢ DO NOT PROCEED WITH FRAMING UNTIL SURVEY OF FOUNDATION LOCATION HAS BEEN APPROVED. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. ,/ __ SOUTHOLP"~WN ZBA $OUTH~L9 TOWN TRUS'rEES /'¢~f%': TYPICAL-JOIST IIANGER FLOODZONE ~~~R , ~ ........... ~~S~E FLOOD DAMAGE PREVENTION SOUTHOLD TOWN CODE. CERTIFICATION OF NAILING & CONNEcTiONS REQUIRED. , "~ t~IAST FLOOR AND SILL ANCH__O~S OCCUPANCY OR' t ~,,j~C,~o,¢d,,~e,~r; " ." ; ...... 7"~-~= USE ' UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY PL UMBER CER T/F/CA TION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WA TER SUPPLY SYSTEM CANNOT EXCEED 2/10 OF I% LEAD. David }'osl Of!'i~: box !6gl Sag Harbin, ~xcw York 1 R~se Residence R'enovafion~ and Addifion~ 'to the Rose Residence 1020 N~W Suflblk A~ Chile ~; Dale: ~ul~,. 15 2004 Foundation Plan '11 12 4 5 DaVid H.Sherwood,A.LA. A~c, hi.tect Sag Hai'bor, New York 11963 ~enovations and Additions To I~he Rose Residence 1020 New Suffolk Avenue Matlttuck, N~w York 11952 Foundation Plan 1 OF: NENq Rose Residence ' , Date:'Ah .... 8. l~ 2 DF- N~ DaVid H.SI~e~WOOd,A,I.A. Sag ~a~or ~c~v York 11963 R'enovations and Additions ,'i 1'o the Rose Residence t 020 Ne~.' Suffolk Avenue Matfimck, New Yolk I Date: Aug, 15, 2004 Foundation Plan t