HomeMy WebLinkAbout32018-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32393
Date: 06/11/07
THIS CERTIFIES that the building ADDITION
Location of Property: 460 DONNA
(HOUSE NO.)
County Tax Map No. 473889 Section 115
DR
(STREET)
Block 15
MATTITUCK
(HAMLET)
Lot 22
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 10, 2006 pursuant to which
Building Permit No. 32018-Z
dated
MAY 19, 2006
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 AND ALTERATIONS, INCLUDING DECK, TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to DAVID & KERRY BRISOTTI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3690
10/17/06
PLUMBERS CERTIFICATION DATED
N/A
~
Rev. 1/81
/h~ J
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE 01' OCCUPANCY
This application must be fillcd in by typewriter or ink and submitted to the Building Department with the following:
A, }'or 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,
L Fina] Approval from llea]th Oept of water supply and sewerage-disposal (S-9 [(mn),
3, Approval of electrical installation from Board of Tire Underwriters.
4. Swom statement from plumber certifying that the solder used in system contains less than 2/1 0 of 1 % lead.
5. Connnercia] 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, }'or existing buildings (prior to April 9, 1957) non-conforming uses, or buildings aud "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
f' features.
2. A properly completed application and consent to inspect signed by the applicant. Ir a Certificate of Occupancy is
denied, the Bui]ding Inspector shall state the reasons therelc,r in writing to the applicant.
C Fees _
]. Certificate of Occup:;ncy - New dwelling $25.00, Addit[cJll,;Jodwelling$25.00, \lterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory budding $25.00, Busincsses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $] 00.00
3. Copy of Celiificatc of Occupancy - $.25
4. Updated C:cliiticate of Occupancy - $50.00
5. Temporary Certificatc of Occupancy - Residential $15.00, Commerci,d $15.0()
Date.
New COllstluction: ___________ ____ Old or Pre-existing Building: ___ ~_
Location of PropCliy _YGD_~ill_'1X [' vee <i !V\G,{h'1LIL ~<
--Nouse No. utree!
Owner or Owners of Property: '\:)a \'\LL.oj]:L~a~iS(5d+;
Suf1c)lk County Tax Map No ] 000, Section __ . \~~___ B]ock
Subdivision
hied Map.
Permit No. ,~d() Lt____lJate of Permit. 5-=-a~~~ Applicant:
Health Dept. Approval: __
Underwriters Approval:
Planning Board l\ppruvaJ:
Request fCll:
Temporary Certificate ____
Final CC11iticatc:
Fee Submitted: $ :;;J:;... c..~)_
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(chcck one)
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~heck one)
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ant Signature
SUFFOl_K
~^.rol~
BURE/U.!
40 Nottingham Drive, Middle Island, NY 11953
Telephone: 6314958136. Fax: 631 9806455. E-Mail: SBEIGS@gmail.com
CERTIFICATE OF ELECTRICAL COMPLIANCE
Applicant: Raymond Electric
Rough In Inspection Date: 10/17/2006
Application NO: 3690
Suffolk County Tax Map NO:
Final Inspection Date: 2/3/2007
Certificate NO: 3690
Building Permit NO:
This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment
and/or work described below, installed by the applicant named above, located at the premise of and not
after the final inspection date above:
Owner: Kitz
Address: 460 Donna Drive, Mattituck, NY 11952
Address of Inspection Site: 460 Donna Drive, Mattituck, NY 11952
X Residential X Indoors
Commercial X Outdoors
New Renovation
X Addition Survey
Service 10
Service 30
Main Panel
Sub- Panel
Disconnects
Transformers
Twist Lock
Heat
Time Clock
Hot Water
GFCI Breaker
Dryer Recpt
Exhaust Fan
TVSS
Other Equipment:
X Basement
X 1st Floor
2nd Floor
Attic
Inventory
11 Duplex Recpt
6 Switches
2 GFCI Recpt
Single Recpt
Range Recpt
Appliance
Heat Pump
Service
Pool
Hot tub
Garage
Shed
Other:
The electrical work and/or equipment described above were inspected and appear to be in compliance with
local, state and national electrical code requirements and this office.
Applicant: Raymond Electric
Inspected by: <?~
Signature: ~
3 Ceiling Fix
4 Wall Fix
8 Recessed Fix
Fluorescent Fix
A/C Blower
A/C Cond
Electric Heat
HID Fix
Smoke Det
Co Det
Pump
Emergency Fix
Exit Fix
Pool Luminaire
License No: 5141-ME
Date of Certificate: 10/18/2006
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.
32018 Z
Date MAY
19, 2006
Permission is hereby granted to:
DAVID & KERRY BRISOTTI
460 DONNA DRIVE
MATTITUCK,NY 11952
for :
ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR
at premises located at
460 DONNA DR
MATTI TUCK
County Tax Map No. 473889 Section 115
Block 0015
Lot No. 022
pursuant to application dated MAY 10, 2006 and approved by the
Building Inspector to expire on NOVEMBER 19, 2007.
Fee $
150.00
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Authorized Signature
ORIGINAL
Rev. 5/8/ 02
3uI P2;
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] ~ULATION
[ KFINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
REMARKS:
,
DATE
-
INSPECTOR
3;1-01 ~ Z-.
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [A INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:~J.Lh ~ '
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DATE /0-/9 --- 00
INSPECTOR _~~.e..--.
31-01 ~ :L
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[XI FRAMING I STRAPPING [ ] FINAL
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[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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REMARKS:
DATE
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INSPECTOR ~~
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TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
REMARKS: ~
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[ ] FOUNDATION 1 ST
~ FOUNDATION 2ND
[ ] FRAMING I STRAPPING [
[ ] FIREPLACE & CHIMNEY [
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
DATE
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INSPECTOR ~ ~
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
J>4 FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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INSPECTOR
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FOUNDATION (1ST)
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INSULATION PER N. y,
STATE ENERGY CODE
FINAL
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PERMIT NO.
3jtl/ ~ c
BUILDING PERMIT APPLlCA nON CHECKLIST
Do you have or need the following, before applying?
Board of Health
~ 4 sets of Building Plans
Planning Board approval
~Survey
Check \~CJ, CC
Septic Form
NYS.D.E.c.
Trustees
Contact:
TOWN OF SOUTHO\-D
BUILDING DEPARTMENT
TOWN HALL'
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
Examined
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.~ fj ,20 0(,
Approved
Disapproved ale
Mail to:
Expiration
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1I/11.20{) 7
,
Phone (03-;)<17\ / I Cl<\-'
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Building Inspector
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\ a.Jlri:S"appli~N\~ ,MO ompletely filled 10 by typewnter or III mk and submitted to the BUilding Inspector "'lth 3
cts ofPlans, ~1!t~ p an to scale Fee according to schedule
m . an showmg locatIOn aflat and ofbUlldmgs on premises, relationship to adJolllmg premises or public streets or
od 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 ifthe work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. Ifno 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.
APPLICA TlON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of South old, 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.
APPLICATION FOR BUILDING PERMIT
,20_
Date
(Signature of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
l"+-'- Lr-'j'L {j\
Name of owner of premises l) (\JV-\-e.l n Y\ d '){~'VL'-tlt t::~ '-- ,,-,0-1:(,- '
(As on the tax roll of est 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.
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1. Location of land on which proposed work will be done: 1~ tt: t I
L\\cC L~"'RC' C \ ' - P -ILL l lLe-c
House Number Street I Hamlet
County Tax Map No. 1000 Section
Subdivision
ilS
Block_l s'
Filed Map No,
Lot
Lot
')J.-
(Name)
.
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exis.ting use and occupancy p~'1'V'\.{)....\"-<"'/\ ^ ( ~.UJ. r -""" .('!
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b. Intended use and occupancy 0 II ; ~,"",A/,^ 0 ./\1 -{\.J.' f't.t..-v'\.A' C.
3. Nature ofwark (check \....hich applicable): New Building Addition ~
Repair Removal Demolition Other Work
4. Estimated Cost i 5b ". (()D K Fee $> I '\0
(To be paid on filing this application)
Number of dwelling units on each floor
S.inrcc,,' C,v\Vt,kd f<:.,},zy\
Alteration
(Description)
5. If dwelling, number of dwelling units g-~
If garage, number of cars <""~'-
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear
Height Number of Stories l.~~<-
Depth
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size of lot Front
Rear
Depth
10. Date of Purchase \ G. \ ") - en
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO----2C-
13. Will iot be re.graded? YES_ NOl Will excess fill be removed from premises? YES_ NO_
\)&v.:cA (I,~",\c\
]4. Names of Owner of premises >'<.('{'.\ 1",<" \ \\ Address Lil,O DC'"".", I \\"~~Phone No. ;j.c\3.. \C{"\ '\
Name of Architect Address Phone No
Name of Contractor ~ \,u('c I( i \ L- Address Phone No.
t\cc,'( ,'v, ( 0V') \"'l \ ,\)Y"\
15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES~NO ~
* IF YES, SOUTH OLD TOWN TRUSTEES & D.E.e. PERMITS MAYBE REQUIRED.
b. Is this property within 300 feet ofa tidal wetland? * YES~ NO~
* IF YES, D.E.e. PERMITS MA Y 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 OF <;'^\~) . .
j(e (I I A . &,. SuN, being duly sworn, deposes and says that (s)he is the applicant
(Nam~ of individual signing contract) above named,
(S)He is the
(,I,\N\1..(
~
(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.
Jr!r.::.to. before me this
, V\;\l ~ day of
Notary P b c
MELANIE DOROSKI
'OrARY PUBLIC, State of New 'lbrll
No. 01004634B70
Qualified in Suffoik County h.
Commission Expires September 30daJ V
20..0.k.
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SUFFOLK oo\.m~Y HEAllJ:H DEPAR'T~EN't'
~~JAN 261976 _ lit D. REF. it S-Scl~ IYO
1 and water supplY
OX sew8gCl di!:lPOS~~ 'lOC'ltion have been
.........~Cllitie:3 fOtrh~~l~epa:r~ullmt and found 7) '/JfJ \
aoted by ;' J.J- 0. V"
to ~tiSfactorY.r-R ~ '. . .', "" ~
Chief ot General Eng1neer~
serVice. NE'A/ .J\.
vv SU~rOLK .
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AVENUE
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7'HB IQClITlON or WEltS' lIND t:E'S",gpJoLS
SHOW/lHEBElN /J.IlE FROM FlF.LD OBS~RVATlON$
AND/OR FROM DI{TJI OBTAINED FRo~~orlfEBS
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SURVEY FOR:
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UNAUTIi~!ZrD Al,UIIATI\)N CJfIIADDlTlONTO
TII" 9UR~EY IS ... VIOLATIO~ OF Bl!CTION
7Z080FTHE:~YOAk9TATEiEOUCATION
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COPIES o~ fHIS Jl.l"",EY MAP /fOr IUiAIIlN9
rHt; LA~ lIlJRVEyOft'S INKEOSULOR
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dI/.ARANrE€D TITLE DIVISION 01'
. ;'A~~RICAN TITLE INSURANCE CO.
tiUAIIA,..TtE' INDleA.'ttD IlE~EON SfiALL IIUN
ONLY TO THl! Pf:RS-PN '011 WHOM mE
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TOWN OF
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ENERGY CODE CALCULATIONS
CHAPlER5
SECTION 501
For:
Detached One and Two Family
(For Non-Electric Heat)
erisa/I-
'/(.0 .J)Ol1hC .f)~/r4
X,II, l < (
Design Criteria 5750 Degree Days
Zone lIB
Per: fhh~ IJ~'.(; 2...7/5
Dated:
SUBSYSTEM AREA DESIGN CODE DESIGN CODE
"lJ" "lJ" UA UA
Exterior Walls / t, 21 0.1/03 0.14 178 . 78 2 2 6. f 9
Ceiling Roof / I:, 9 {, 0.0.3'/0 0.031 57. 6 v 52.'15
Floor Over Unheated Space / b ft (),05 0.05 6>'I,6CJ 8'/,{,O
Heated Slab On Grade 6.5
Unheated Slab On Grade 4.5
Basement Wall 0.1
Crawl Space Wall 0.06
32C>,lJ8 3'-3.79
NOlES.
Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage
Building Envelope Systems to meet requirements of Section 50 I
The mechanical systems and equipment including:
HV AC Equipment, HV AC Systems, Duct Systems, Ventilation Systems and Insulation of Piping Systems to meet
requirements of Section 503
Service Water Heating Systems & Equipment to meet requirements of Section 504
Electrical & Lighting Systems & Equipment to meet requirements of Section 505
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To the best of my knowledge,
belief, & professional judgement,
these plans are iin compliance
with.the code.