HomeMy WebLinkAbout30819-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-3l944
Date: 10/23/06
THIS CERTIFIES that the building
ADDITIONS
Location of Property: 615 EAST
(HOUSE NO.)
County Tax Map No. 473889 Section 122
LEGION AVE
(STREET)
Block ~
MATTI TUCK
(HAMLET)
Lot 30
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 2, 2004 pursuant to which
Building Permit No. 30819-Z
dated
DECEMBER 3, 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 FAMILY ROOM AND DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to ROBERT M & PATRICIA PATCHELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
2035404
12/06/04
PLUMBERS CERTIFICATION DATED
N/A
~~-
A thor~zed S~gnature
Rev. 1/81
.___._~_ ~ I'
r2 ' \
20
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 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 2/1 0 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:
.J
Date.
/0 - (o,Q6
Old or Pre-existing Building:
~
(check one)
Ih 4--ITJ TV l-/<...
Hamlet
Location ofproperty: ~ 7 (' e /H T L.. e&1 o.J /tV.(
House No. Street
Owner or Owners ofproperty: 1(0 1M Ell 'J () f'r TL 1-+ ~(/ L
Suffolk County Tal' Map No 1000, Section ~Il- V Block 3
. .
Lot 3 c)
Subdivision Filed Map.
Permit No. 3 o~ 11-4,ateofPermit._r'2.---~ 1-o0](pplicant:
Lot:
'KD68V1Prr fltlLIi~ll.-
Health Dept. Approval:
Planning Board Approval:
Request for:
Underwriters Approval:
Fee Submitted: $
Temporary Certificate
:< .s- ~'"
x... "
Final Certificate:
~. 71?05
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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
ROBERT PATCHELL
615 EAST LEGION AVE.
MATTITUCK, NY 11952
ROBERT PATCHELL
615 EAST LEGION AVE.
MATTITUCK, NY 11952
615 EAST LEGION AVE. MATTITUCK, NY 11952
2035404
Certificate Number:
2035404
Block:
Lot:
Building Permit:
BDC:
n511
Described as a occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, sun room, Outside,
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 6th Day of
December, 2004.
OTY Rate
Rating
Circuit~ ~
Miscellaneous
as built-2000
Wiring and Devices
Outlet
14 0
14 0
9 0
5 0
7 0
I 0
I 0
Fixture
Incandescent
General Purpose
General Purpose
General Purpose
GFCI
Outlet
Receptacle
Switch
Receptacle
Paddle Fan
An as built visual inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is
believed to be in comforrnance with the applicable reference standard for the estimated period of construction of the premises wiring system
seal
of I
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.
30819 Z
Date DECEMBER
3, 2004
Permission is hereby granted to:
ROBERT M & PATCHELL
125 RAFF AVE
FLORAL PARK,NY 11001
for :
CONSTRUCTION OF A NEW FAMILY ROOM AND DECK ADDITION TO AN
EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. (THIS REPLACES BP #26218-Z)
at premises located at
615 EAST LEGION AVE
MATTI TUCK
County Tax Map No. 473889 Section 122
Block 0003
Lot No. 030
pursuant to application dated DECEMBER
2, 2004 and approved by the
Building Inspector to expire on JUNE
3, 2006.
Fee $
150.00
ORIGINAL
Rev. 5/8/02
Jogl, z
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING p<f FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
~ 0
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d- ])~cl<
/
DATE
/;}--~--oi
INSPECTOR~'~
2Guf&
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS; ~ CA.A ;
[ ] R~ PLBG.
[ ~SULATION
[ ] FINAL
DATE &/r (vo
It
INSPECTOR
?--0
J--~ 'V{ u-
765.1802
BUilDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
NDATION 2ND
CE & CHIMNEY
/
REMARKS:
{Y'--:
I
DATE
lc5t>
INSPECTOR
~
d0' ~/f~
765-1802
BUILDING DEPT.
INSPECTION
[ OUNDATION 1 ST
[ FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE
V'lKS'
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
/'
V
#1~ ~~.at~
~~ ~~
DATE
Charles M. Thomas, R.A.
I
P.O. Box 877
Jamesport, New York 11947
(631) 727-7993
...........................................................................................,
. ';, t
December I, 2004
Building Department
Town of South old
53905 Main Road
Southold, N.Y. 11971
Re: Patchell Residence "As Built Conditions"
PERMIT# 26218 Z
Dear Building Dept.:
Upon visuaLinspections of the above referenced residence I can certify that the framing and the
installation Of the insulation conformed with or exceeded the New York State Building Code.
Please feel free to call me with any questions you have.
,::c:~EDAAC>' '
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OWNER
LAND
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f /t,GE
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
Hause Plat
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Total
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TOWN OF SOUTHOLD Pl\\JPERTY RECORD CARD
o DIST. SUB.
LOT
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ACR.
,320
TYPE OF BUILDING
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COMM. CB. MISe. Mkt. Value
IMP.
TOTAL
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01.30 ;:(90
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Value Per
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FRONTAGE ON WATER ~ 0 Q I?'!! ~
FRONTAGE ON ROAD & j- .
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DEPTH
BULKHEAD
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Exfe~ 3-~ . 'FtJ
~I j(3~::; tf, 7:l ), 0/ & Basement Floors t: I ,I.. K.
Extension Ext. Walls t rJ/ Jlj Interior Finish /1,::/ /.)f;: lR.
&lv.' I' I/,'! ,
Extension Fire Place Heat (3 I( -:; DR.
Pee. Ie. t'~( /5' ;; tllO -- S:l.. Type Roof Ju it; , Rooms 1 sl Floor
.~j BR.
Parch Recreation Room Roams 2nd Floor FIN. B.
Porch Dormer
Breezeway Driveway
Garage I
Patio
O. B. U/o,(," .s-O
Total ~2.I,'3 I ([.ho I
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DATION
;R FRAME &
PLUMBING
JT.ATION PER N. Y.
iTATE ENERGY
CODE
FINAL
I'J..- '1 -0 Y-
ADDITIONAL COMMENTS:
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.FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL: 765-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEy....................... .
CHECK .........................
SEPTIC FORM ...................
NOTIFY: ~~(..~ ~__f
CALL.. 71-1. .-:-S"')t}P
MAIL TO:y..O.,.e~..~77.
..~~~D.M....~......
fucanined................., 19....
Approved.... .J.~.:.'?-.!..., 19.~.1}
30 ~ j 9 t
Pennit lb. .-.2k.~f?.~
Disappnoved alc ........................... ..... jj
.........~..I.'..r.:..n~\.:..,:......'I....... ............. )@A
,!\"l.r" .....~..
r . 1'1' ~ "
1
. ..
~A I 9 1999
PLICATION FOR BUILDING PERMIT
L.
.....-A
Date. .1!n1.-.I.i..... ,1911
~_J
INSTRUCTIONS
a. '!his application DUSt be ~letely filled in by typewriter or in ink and subnitted to the &Iilding Inspector wil
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 p.lblic
streets or areas, and giving a detailed description of layout of property DUSt be drawn on the diagran lihich is part of
this application.
c. The ""rl< COIIered by this applicationl1BY not be COlIlEnced before issuance of &Iilding Pennit.
d. Upon appnoval of this application, the &Iilding Inspector ,rill issue a &Iilding Pennit to the applicant. Such
penni t shall be kept on the premisea available for inspection throughoot the 'WOrk.
e. lb building shall be occupied or used in lihole or in part for any p.JrpOse lihatever until a Certificate of
Occupancy shall have been granted by the &Ii lding Inspector.
APPLICATI<!l IS IEREIIY MAlE to the fuilding Department for the issuance of a fuilding Pennit pn-suant to the
fuilding Zone Ordinance of the Town of Soothold, Suffolk Coonty, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, r for rem:lI1al or dem:>lition, as herein
",.",,"". n..... i_ ....... ~ -, wi'" .n ....i"",. '-, 0 "'\ l"''''' ""'. ....i'" ""'. ""
regulations, and to adnit authorized inspectors on premises and in buil i for ssary inspections.
.. ....... ...........(,.~..~~S'
(Signature of applicant, or naue, if a corporation)
-r...q..~..~J.l...~~.~..J.l1., f-
(Mailing address of applicant)
State whether applicant is owner, lessee, agent,~ engineer, general contractor, electrician, plwber or builder
...........!C:~....~....~~5..............................................................,.......
Name of owner of premises ....~~.~..~,...~.....~~~~~~........................................
(as on the tax roll or latest deed)
~~ .~~~~~~~~~: .~~:: .~~ .~~~ .~~~~~ officer.
(Name and title of corporate officer)
-'
&Iilders License lb.
Plwbers License No.
Electricians License lb. .....................
Other Trade's License lb. ....................
I. Location of land on lihich proposed 'WOrk will he done. ... .... ................ ........ ........ ................... '"
........................ ..~T. ..~~l.Cu..l..... Av.~N.~k;............. .~~. :W~...............
Hoose lbdJer Street Haulet
Coonty Tax Map lb. IlXXl Section. .l:k:l......... Block ~ 3.......... Lot .... ??3. Q...
Subdivision ...................................... Filed Map lb. ............... I..ot ...............
(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 ......~kCJ....=t..I~.....~4~:Lt:~~2":\.,....................
,I I '
....,y:,.
't,l:, .)-
...;.
_.p..r......,'.:.."
Nature of work (dleCk ",Md, applicable): New Iklilding .......... h1dition .. ~.... Alteration ..........
Repair ............ Ramval ............. Dennlition ............ Other Work ..................................
(Description)
EstillBted Cost ~:ht?.,.aP.9............
fee ......... ..... ...... ................ ..........
(to be paid on fiI ing this application)
If do.;elling, tuJber of dwelling units ....~.... lumer of dwelling mits on each floor .7:':"":':..........
If garage, nunber of cars ....~.............................
If husiness,COIJrercial or mixed occupancy, specify nature and extent of each type of use. .';..... .'.............
Oinensions of ~isting structures, if any: Front.::$5'..1-...... Rear.. SI. ~l....... Depth ..1:7..........
l1eight ... ;::?f.,................. IUtber of Stories...'1..................YO I
O' . f . I 1 . add' . ...... J X
lrneOSlOOS 0 same structure ~tl a teratloos or Itlons: Front ............... Rear .. .~........
Depth .................... Height .................... Ibtber of Stories ....,..;..........
Ohrensions of entire new construction: Front................ Rear ............... Depth ..............
11e ight ......................... IUtber of Stories .....................
Size of lot: Front.. .. . .. .. .. . .. .. .... Rear .................... Depth ....................
l. !late of Purdlase ..................... Nare of Forner Omer ........................................
I. Zone Dr use district in ....ich premises are situated ..............................................................
1. Does proposed construction violate any zoning law, ordinance or regulation: ...v.9.................
l. Will lot be regraded ....IJ.9............. will excess fill be Te1'O\/ed fron prEmises: YES I{)
i. Nares of Omer of pranises M~.f!~,..fA<:t"(,.~ h1dress 1:;~.~~t;lQ.x.~.. llione lb. .............
Nare of Architect ~..~.$...... h1dress 't'!~:J1~.~'J.l.~~llione Ib.Th1~5:U!P..
Nare of Contractor................................... h1dress .............................. .Phone lb.
5. Is this property within 300 feet of a tidal wetland? "YES.......... I{)..........
"IF YES, roJIlnn TCHl 'IllllS'l'l'ES 1'EIMIT MAY BE 1'lIlQJIRED.
PLOT DIAGRAM
locate clearly and distinctly all buildings, ......ther existing or proposed, and indicate all set-back dhrensions
ran property lines. Give street and block IUlber or description according to deed, and sholl street nares and indicate
!lether interior or comer lot.
r^1E oc- l'I::II YORK,
llNIY U' ....... .?'.....q;;s~...... 55
..~...~...~..~~........being duly """01, deposes and says that be is the applicant
'lmI! of individual signing contract)
JOVe oared,
? is the......... ~~ tOo... ..~,1k1~.................................................
(Contractor,~ corporate officer, etc.)
r said owner nr owners, and is duly authorized to perfonn or have perfonned Ule said work and to lIBke and file this
pplication; that a.l1 staterrents contained in this application are true to U,e best of his knowledge and belief; and
l,at the work will be pedo tile lIBmler set forth in the application filed therewith.
WOOl to before JTe this
\~
..... .... ..... . .. .day of
Ibtary Publi ..
... ~
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Area= 4,036 S. F. ~~
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I' I v AVENUE r/cs.
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i. OF GUTTER BASE 0 ON SURVEY BY
OTTO W. VANTUYL MADE IN APRIL IV88.
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SURVEY FOR
ROBERT PATCHELL a PATRICIA PATCHELL
NOTE' I. . = MONUMENT
2. TOTAL AREA = 14,593 S.F.
3. SUFFOLK COUNTY TAX MAP
DIST.'OOO SECT.'.. BL!!!!!...LOT.ollo
AT MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY. NEW YORK
DATE
SCALE'
NO.
APR. 4. 2000
NOV. 9, 19B4
NOV. 9, 1984
I" = 20'
84.1194
* UNAUTHORIZED ALTERATION OR AoorTlON TO THIS
SURVEY IS A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW
. COPIES OF THIS SURVEY NOT BEARING THE LAND
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALID TRUE COpy
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO
THE PERSON FOR WHOM THE SURVEY IS PREPARED,
AND ON HIS BEHALF TO nu TITLE COMPANY, GOVERN-
MENTAL AGENCY AND LENDING lNSTlTUTlON.LISTED
HEREON, AND TO THE ASSIGNEES OF THE LENDING
INSTITUTION. GUARANTEES ARE HOT TRAHSFERAIL(
TO ADDITIONAL INSTITUTIONS OR SUBSEOUENT
OWNERS.
* DISTANCES SHOWN HEREON FRO" PROPERTY LINES
TO EXISTING STRUCTURES ARE FOR A SPECIFIC
PURPOSE AND ARE NOT TO IE USED TO ESralllSH
PROPERTY LINES OR FOR THE ERECTION 0' fENCIES.
BRANDIS & SONS. lfoll.
CERTIFIED TO'
YOUNG a YOUNG
400 OSTRANDER AVENUE
RIVERHEAD. NEW YORK
ALDEN W. YOUNG,PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S. LICENSE NO. 12845
HOWARD W. YOUNG, LAND SURVEYOR
N.Y.S. LICENSE NO. 45893