HomeMy WebLinkAbout32393-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32910
Date: 03/05/08
THIS CERTIFIES that the building
ALTERATION
Location of Property: 265
(HOUSE NO.)
COUnty Tax Map No. 473889 Section 139
FREEMAN AVE
(STREET)
Block 3
MATTI TUCK
(HAMLET)
Lot 37
Subdivision
Filed MaP No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 19, 2006 pursuant to which
Building Permit No. 32393-Z
dated SEPTEMBER 27, 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 ALTERATION TO BASEMENT IN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to KATHLEEN & KEITH HARRIS
(OWNER)
of the aforesaid building.
SUFFOLK COUI!lTY DBPAR'l'MBlIIT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
117140C
06/22/07
PLUMBERS CERTIFICATIOIII DATED
06/22/07 H2M LABS, INC
~~
Rev. 1/81
.
Form No.6
TOWN OF SOVTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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This applicalJon must be filled in by typewriter or ink and submitted to the Building Department \Yit~g:
A. For uew building or new use:
I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fonn).
Approval of electrical installation from Board of Fire Underwriters.
Swam statement from plumber certifying that the solder used in system contains less than 2/l 0 of I % lead.
Conunercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
G. Submit Planning Board Approval of completed site plan requirements.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
I. 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
I. Cel1ificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swinuning 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. Cop)' of Certificate of Occupancy - $.25
4. Updated Celtificate of Occupancy - $50.00
5. TCll1por<lry CCl1tficate of Occupanc)' - Residential $15.00, Conunerclal $15.00
D<lte.___~ ~.&__
New Corrstl1lct;on: Old or Pre-existing Bnilding: ~~ (check one)
LocalJon or Property: )..r.2.-. -H--L-t.~_ ~~ ~....L.
House No. Street '-f.o ,JsDI' J/J/ (4/1//<./U0 Hamlet
Owner 01 Owners or Propelty: ~l j-{... _ ~ (""~~____ ____ _ m.____ ____~__ __ _~
Suf!;>Ik County Tax Map No !OliO, Section
i ?/\___ Block u 3______ ~ Lot _ 3:-L__
Suhcll \I':j(jll
______~__~_ ___ Filed Map~_~.___ _ Lot:
Pernlll No 3.2 3 f.s L- Date ofPcnnit:
~~ _~_ Apphcanl ___ _______~._~
Health Ilcpl .\pploval' _____~_ ___~
Underwriters Approval:
PlallllIng l30dld ApprovaL __________
Requc.';l fur:
Temporary Certificate _
Fillal CCltlficale.
...-----~ _ (check olle)
Fee Subll1llted. $ __';'_2.~ ____~__
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--------------------------
Applicant Signature
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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.
32393 Z
Date SEPTEMBER 27, 2006
Permission is hereby granted to:
KATHLEEN & KEITH HARRIS
PO BOX 513
MATTITUCK,NY 11952
for :
ALTERATION TO AN EXISTING BASEMENT AS APPLIED FOR
at premises located at
265 FREEMAN AVE
MATTITUCK
County Tax Map No. 473889 Section 139
Block 0003
Lot No. 037
pursuant to application dated SEPTEMBER 19, 2006 and approved by the
Building Inspector to expire on MARCH
27, 2008.
Fee $
195.00
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, Authorized Signature
ORIGINAL
Rev. 5/8/02
. . 'i~," lAU~~ I~C.
575BroadHdloN Road, Melvie NY 11747
(631)~.FAX:(631)~ NYSOClH 10# 10478
HARRY GOLDMAN WATER TESTING
MAIN ROAD
MATTITUCK, NY 11952
Attn To : 631-298-4640
Federal 10
Collected : 6/22/2007 10:20:00 AM
Received : 6122/20073:35:00 PM
Collected By : JD99
Copy : Original
CC
LABORATORY RESULTS
Lab No. : 0707288-001A
Sample Information...
Type : Solder
Origin: Distribution
Routine
Point No : 4
Location:
Client 10. : KEITH HARRIS
265 FREEMAN RD,MA TTITUCK SOURCE(CWL-
BS) BASEMENT (473889-139-03-037132393)
Parameter(s)
Lead
Results Qualifier D.F. Units
0.04 1 %
Limit
0.2
Method Number
SW6010A
Analvzed
06/28/2007 1:42 PM
Resull(s) reported meet(s) Regulatory Umi~s).
Result(s) flagged with * Exceed Regulatory limlt(s). limit noted.
D.F. = Dilution Factor
Page 1 of 1
f~ ~~<~~J
Laboratory Manager
Date Reported :
6/29/2007
J~313Z
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
REMARKS:;r~ tK '
~ v--'r t~'~~'~
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
t><( FINAL 4- :
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
DATE 3 - 3 - 0 'I
INSPECTOR ~~
3 r;.. 31 3 :z...
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING ~ FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
INSPECTOR
~~
.
FIELD INSPECTION REPORT DATE
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
COMMENTS
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ADDITIONAL COMMENTS
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J~393G
BUILDING PERMIT APPLICA nON CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
TOWN OF SOl}THOLD
BUILDING DEPARTMENT
TOWN HALL .
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthoIdJ PERMIT NO.
~~:~~i]
Examined
Approved
Disapproved alc
Mail to:
Phone:
~/J-?2o~g
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Expiration
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( Building Inspector
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APPLICATION FOR BUILDING PERMIT
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Date
6/~~
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,20 tJ(,
INSTRUCTIONS
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\...a,.:I:~'appticat1onMUSTb;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.
APPLlCA nON 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
wili~;=' ;""P""'" '" p=;,," '"' ;" "';W;", f~ "'==> ;""P~;""". ~'
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(Signature pplicant or name, if a corporation)
9o&ri 5/3 m~YL1~
(Mailing address of applicant)
U 'IS' ..L
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
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Name of owner of premises .;I..{,5 -K~ ~
(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.
Pltnnbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
.;1.." 5 ..f" (" JU!.w\. CL->\... <;L L O'Y.L 1'\ ~ \vc.l:.
House Number Street Hamlet
County Tax Map No.1 000 Section
Subdivision
/3"
Block 0 3
Filed Map No.
Lot "3 7
Lot
(Name)
,
2. State existing use and occupancy of premises and intended use a.t).d occupancy of proposed construction:
a. Existing use and occupancy ~e <; ~ cL<-t.\.~-'!.. . ..
b. Intended use and occupancy
'\< .e..-S-\ ~e.L
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration K
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
1
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
/VIA
,
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
1
Dimensions of same structure with alterations or additions: Front rM:l A
Depth JVV:> ;::,. Height.....AU:' .A Number of Stories
Rear /YI-O A
.AU:' A
8. Dimensions of entire new construction: Front '/\t>.b..
Height fYU A Number of Stories
Rear ~ A
M.e. A
Depth ~ A
9. Size oflot: Front
I~()'
Rear
100
Depth \,.J 17"
"Tu r~
E JAt)'
10. Date of Purchase
IHI;
Name of Former Owner
II. Zone or use district in which premises are situated ---.Regr!.j!,lt.Ua.J
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO---X-
13. Will lot be re-graded? YES_NO 1 Will excess fill be removed from premises? YES_NO L
pel &,t 5"13
~(,j; fio~ '2J
14. Names of Owner ofpremises~ddress
Name of Architect :JD"-I\. "'""..:z.i Address
Name of Contractor l\P..ak.t ~ ~t'r' S Address
.YA-m,::;.
Phone No. c,,3/.~q8-S:l.S~
Phone No ':il. "o~ - (1655
Phone No. '
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES 1- NO ~
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES -L 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 OFS vPtt,L-~
k~ ITH, +\:J\.R~I.:s- being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Ov.:> N E~
(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.
20 0 ~
U4-
Signature of Applicant
KIERAN M. CORCORAN
QUALIFIED IN SUFFOLK COUNTY
NOT"RH02C06118838 1'/
MV COMMISSION EX~IReS DEC. i. 2..!Ei.
09/26/2006 06:33
6312089656
BEATTY HARVEY LLP
PAGE 02/02
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Pennit Number
SEP 2 7 "3
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RltSeJakk COID.pliance-eekw.cate Checked BylDato
New York State Energy Conservation Construction Code
REScheckSoltwaro Version 3.5 hlease Ie
Data filename: Untitled.roll:
TITLE: Harris Resimnce - Interior Alterations
COUNTY: Suffolk
STATE: New York
HDD: 5750
CONSTRUCTION TYPE: Detached I or 2 Family
HEATING TYPE: Non-Electric
DATE: 09126/06
DATE OF PLANS: 09/11106 (Revised)
PROJECT INPOm,.,/.TION:
Freeman AveJ.ue
Mattituck, Ne,,: York
COMPANY INFOR~tAnON:
John Tanzi Archit<:c,
COMPLIANCE: Passes
MaximwnUA" 1:'6
YourHomeU/,= ,25
0.8% Better Thaal Ctlde (UA)
Gross
Area or Cavity
Perimeter R- Value
Glazing
Cont or Doer
R-Value lJ-Factor ~
Wall I: Wood Framl:, 16.0.c.
Doer I: Solid
Door 2: Solid
Basement Wan ': Masonry Block wilb Empty Cells
Wall heiaht: 7..1'
Depth below grade: 6.7'
Insulation depth: 7.5'
Window I: Wood Frame:Doublc Pane
250
18
18
960
0.450
0.450
18
8
8
85
13.0
0.5
5.0
0.5
16
0.360
6
COMPLIANCE S. iA TEMEN!: The proposed building represented in this docUment is consistent witb the buildinll plans,
specifications. and other celculations submitted with this permit opplication. The proposed systems have been designed to meet the
New York Stato Energy Conservation Construction Code requirements. When a hgislered Design Professional has stamped and
siened Ibis page, they are attcsti to the beat ofhis/her Jcnowledge. bolief, and professional judgment, such plans or
specifications are in campI' is
.
Dalt:!!J -~-e1t#J
BuiJderlDesigne.r_
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