HomeMy WebLinkAbout33702-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 03/07/08
1110: Z-32913
THIS CERTIFIES that the building ALTERATION
Location of Property: 715 EAST
(HOUSE NO.)
county Tax Map Il1o. 473889 Section 38
GILLETTE DR
(STREET)
Block 4
EAST MARION
(HAMLET)
Lot 14
Subdivision
Filed Map Il1o.
Lot Il1o.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 19, 2007 pursuant to which
Building Permit 1110. 33702-Z
dated
FEBRUARY 22, 2008
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 GLASS STORM PANELS TO AN EXISTING COVERED PORCH AS
APPLIED FOR "AS BUILT."
The certificate is issued to MARY DIAZ
(OWNER)
of the aforesaid building.
N/A
SUFFOLK cotJ1IITY DEPAR'I.'MBIIIT OF BElU.TH APPROVAL
ELECTRICAL CERTIFICATE Il1O.
N/A
N/A
PLUMBERS CERTIFICATION DATED
Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICA nON FOR CERTIFICATE OF OCCUP ANCY
Tlus application must be filled in by typewriter or ink and subntitted to the Building Department with the following:
A. For new building or new use:
I. 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 fann).
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 ofl% lead.
5. Commercial building, industrial building, multiple residences and sintilar 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:
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 Celiificate 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, AJterations to dwelling $25.00,
SwillUlling pool $25.00, Accessory building $25.00, Additions ta 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 Celtificate GfOccupancy - $50.00
5. TelllpOl'm)' Celtificate of Occupancy - Residential $1500. Commercial $15 00
Date
Location ofProperiy:
'--.J.
11'5
New ConstlUclion:
House No
Old 01' Pre-existing Building:
6i II e-lt -e br
~ (check one)
&5+ rY\0/2/'{)n
Hamlet
e
\\\OJ'i
Street
biGj2
3'0
Owner or Owners of Property
Suffolk County Tax Map No 1000, Section
Block
y
Lol I Y.
SubdiVision
Filed Map __~
Lol
Permit No
3?l1 O=-~ Dat~ ofPellllil. d I d~.) 8
_ Apphcalll__ __ _______
Health Dept Approval._.
UnderWriters Approval. _
Planning Board Approval:
Request for'
Temporary Certificate __
r _~
;J~~_____
Final Ceilificate: ..~. _/-J~bJ::~__
//;~---/ )
~~~
Fee Submitted. $
Go -z~dqI3
~G 1?:'~ 10
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.
33702 Z
Date FEBRUARY 22, 2008
permission is hereby granted to:
WILLIAM A & WF MATTFELD
715 EAST GILLETTE DR
EAST MARION,NY 11939
for :
AS BUILT ALTERATION (INSTALLATION OF GLASS STORM PANELS) OF AN
EXISTING COVERED PORCH AS APPLIED FOR
at premises located at
715 EAST GILLETTE DR
EAST MARION
County Tax Map No. 473889 Section 038
Block 0004
Lot No. 014
pursuant to application dated DECEMBER 19, 2007 and approved by the
Building Inspector to expire on AUGUST 22, 2009.
Fee $
400.00
ORIGINAL
Rev. 5/8/02
".' .
SUAVEYEDFOR:- MUlA/<-! 4 , E'{/ct.yA/ M M47TFelD
\.OCATEDAT EAST M~IfIO/V1 TOtUM of..sac/plCJ~D, ..5t/FFOLIf'Co.l NY
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WILU.4M .4 t'--'(4TTFELO F EVELYN H ,u;47TFcUJ
~"fr}l ~:;;:-':-"-c:i:J:~/...-.- /r FILE NO.IS716
""AWN RV .. c,QC;
100.00
~7Z
SURVEYED FEB. ICJ,
19c9 (i BY
WIUIAM Roo SIMMONS III
70 WEST MAIN STREET
EAST ISUP, L.I.. N. Y.
PAGE GRID
702-
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] ~LATION
[D1'FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
CO
DATE
gis/C)?
/ !
INSPECTOR
~
,
.'
FIELD INSPECTION REPORT DATE I
.
FOUNDATION (1ST)
---~--------------------------------
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
--- --.
----.-.---- -----.-
INSULATION PER N. Y. --
STATE ENERGY CODE
FINAL
.
.
3/1>/l y- or' .., t.D
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ADDITIONAL COMMENTS
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COMMENTS
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL .
SOUTHOLD. NY 11971
TEL: (631) 165-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
20 cj
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Realth
""'4 sets of Building Plans
Planning Board approval
-------... Survey ~ Q ~
PERMIT NO. 33-:t-O.;;l~ Check ,-\00',00
Septic Form
N.Y.S.D.E.C.
Trustees
Stonn-Water Assessment Form_
Contact: cPJ2f t,t () 1n~
Mail 10:
Approved
Disapproved ale
,20_
Examined
Expiration
,20
Phone:
APPLICATION FOR BUILDING PERMIT
Date bECEMBEI< 11 ,20~
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 oflot 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 Irispector 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 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.
6i
(Sign
jo THRA.sf1E~ AilE) BELLPD~I NY
(Mailing address of applicant) 1/7/3
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
'PREVIOlJ" DWN~f\
Nameofownerofprernises M ~ WiLLI T EVnYtJ /VI T
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
relJlO oS w(lU~
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on which proposed work will be done:
7/5 EAST 6ILLETr~ i)R. EAST MAKION
House Number Street
NY
Hamlet
County Tax Map No. 1000 Section
Subdivision
M,
Block 4
Filed Map No.
Lot I'/-
Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of propo~ construction:
a. Existinguseandoccupancy_privll.le h"rne.. '.
b.Intendeduseandoccupancy fo enclose. back C ntG
;4.r1f' -'I ~r
Addition /-~~.,"<<MAlteration
Other Work
!S
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
(Description)
5. If dwelling, number of dwelling units
If garage, number of cars .;l.
Fee ."400.00
(To be paid on filing this application)
Number of dwelling units on each floor J
4. Estimated Cost
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
Depth
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
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 oflot: Front
// ,:,
Rear
//0
Depth / C1 e.J
10. Date of Purchase J UL Y 0100,
,
Name of Former Owner WILLIAM A. E EvelYN M.MATTF!Ol..~
.
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_
#"7/d' GIt.t"rIT~,t.
Address /4:rr ~""It,..._ Phone No.
Address"'''' ,,<I- "";f-<'N ......of- "Phone No 2 91? - .:r .2~.z.
Address ~ ~~".w ".,/. Phone No.
14. Names o~~cofpremiSeS,lf1A:l.Y 4;"A-.a.
Name of ^ "'f' A' a' 6'",~../ ;..
Name of Contractor
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _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_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.
18. Are there any covenants and restrictions with respect to this property? * YES_NO_
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
COUNTY OF, )lAJ'fOLsrt.
v.e,,\ 1vI
(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.
Notary Public
20 tf7
N018~;~~A.~=y~~ 1J7~
e \.1~~ -,75450
Qualified if, !:;,,,,,,).. County Signature of phcant
My Commission Ex~"8S March 31, 2011
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TO THE BEST OF MY KNOWLEDGE BELIEF AND PROFESSIONAL JU
THESE PLANS ARE IN COMPLIANCE WITH THE NEW YORK STATE B II.:
STOCKDRAFTING FORM NO. 101-81
C;,: /tS'~
J7;:".t~
/'~~U-
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK ST ATE.
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AP R ED AS NOTED
DAT~ r B.P. # 33~.z.
FEE 'tJ-- BY: r -
NOTIF BUILDING DEP MENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH. FRAMING & PLUMBING
3. INSULATION
4. FINAL. CONST9UCTION MUST
BE COMPLETE FOR CD.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COrvlPL Y WITH ALL CODES OF
NEW YORK ST A T~ & TOWN CODES
AS REOUiRED N~~ c,Cio,JDITIONSOF
__ SC:"::HS'_D 10\\1:; Z9ft.
so_ '.::: - J")~ ?;'i~~!NG BOARD
SC,'<iLG T!),M; ~RUSTEES
NYS DEe
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( /Is if" /L,r A.'Ei4/( ?C>AC /./
SCAL.E % ~:-, I
DATE / // 6;ij"
APPROVED BY
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DRAWN BY de J
REVISED
7/,5" - RA:s'r- G/LC".E :T:TE,tM EAr-;- .h?,/ut/.... .A/-Y'
DRAWING NUMBER
,2008" - /
.
TOWN OF SOUTHOLD PROPERTY RECORD CARD
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COMM. CB. MISe. Mkt. Value
IMP.
TOTAL
DATE
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-I./[aft-{Nd +v D/a 2. $ L.j 2-0, DOD
AGE
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FARM
BUILDING CONDITION
NORMAL
Ba.OW
ABOVE
Value
Acre
Value Per
Acre
'Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
()
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