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34230-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33369 Date: 10/31/08 THIS CERTIFIES that the building ALTERATION Location of Property: 1865 WESTPHALIA RD (HOUSE NO.) (STREET) County Tax ~p NO. 473889 Section 141 Block 1 Subdivision Filed Map No. Lot No. __ MATTITUCK Lot 4 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 70, 2008 pursuant to which Building Permit No. 34230-Z dated OCTOBER 15, 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 "AS BUILT" ALTERATIONS TO AN EXISTING NONHABITABLE ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to LORI CARSON of the aforesaid building. (OWNER) SUFFOLK CO~]~[Y DEP~]{T~T OF H]~ALTH ~_~P~O~AL E~.~t-£KICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'r~U N/A N/A N/A ~~A hori z e~ Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~]ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34230 Z Date OCTOBER 15, 2008 Permission is hereby granted to: LORI CARSON 1865 WESTPHALIA RD MATTITUCK,NY 11952 for : AS BUILT ALTER3%TIONS TO NONHABITABLE ACCY GARAGE AS APPLIED FOR. at premises located at 1865 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 141 Block 0001 Lot No. 004 pursuant to application dated OCTOBER 70, 2008 and approved by the Building Inspector to expire on APRILFee $ 200.00~~/~ ~i' 15~-~0. ~--~/~ ~rt-h'-o r i z e~ S ignat urT~'~ ORIGINAL Rev. 5/8/02 '-h [~ (~ l~,t \'~ ~;; ~ TO~rNOFSOUTHOLD ~,~~-i ~---~ [ [1| i B U IL D TI~&D~EitP~A~q[ MEN T T~N OF~UT~ ~PI LICATION FOR CERTIFICATE OF OCCUPANC~ This application must be filled in by typewriter or ink and sub,rotted to the Building Department with the following: A. For new building or new use: 1. Fma[ sm-ray of propeity with accurate location of all bnildmgs, propelty lines, streets, and unusnal natural or topographic features. 2. Final Approval from Health Dept. of water snpply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters 4. Sworn statement fi'om plmnber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Colrdnercial building, industrial building, multiple residenkes and similar buildings and installations, a cel~ificate of Code Compliance from architect or engineer respgnsible for the building 6 Submit Planlmlg Boald Appioval of compleled site plan ~equirements. B. For existing buildiugs (prior to April 9, 1957) non-confoirming uses, or buildings and "in-e-existing'' land uses: t Acctuale survey ofl)~Ol)e~%' showing all properly lines. ~treets. building and uuusual natmal ot ~opogral~hic features * 2 A properly complcled application and consent to inqoecl signed b5 the applicant ifa Ce~tificale of Occupancy is denied, il~c Building h~spe< m~ shall slate the reasons flicrefor in writing to tiaa applicaul Fees Swimming pool $25.00, Acco,so~3 builcliug 525 00, Additions to accessory building $2500, Businesses $500(I 3 Copy of Certificate ogOccup:l~tcy - $25 4 Updated Certil]ca~c of ()ccupaucy $5000 5 Tcmpoia~y Ceitificale of Occul)ancy Residential $15 00, (;ommercial $150(I New Construction: ()Id o~ Ptc-existiug Building: ~ (check one) I louse No Slreel Hanflet Subdix tsion _ }'tied Map 1 Heallh Dept Approval: llndemqilers Approval: Plamfing Boaid Approval: Request fu~: Temporary Certificate Fee Snbmitted: $ ~' 00 Final Certificate: (check one) Applica~t Sign~ture~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ IFOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION ~)~ FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE /~)'-~ ~' o ~' INSPECTOR COM2VI~NTS DATE IFI~,LD ENSPECTION Pd~P~RT FOLdeD ATION (1ST) -- FOI~DATION (2ND) ROLiGH FI:C,x~'vfl]N-G & LNSL~ATION PER N. Y. STATE E3TERGS:' CODE FI2N~,kL AJ3DITIONAJL COM]VlENTS rO~ NOTIFY B NC' I '', \ 7654802 9 AM TO.4 PM FOR THE - ~ FOLLOWING FOUh~DATION - ~O REQUIRED FO~ P~UR~ CONCRETE 2. ROUC~4~. FRAMING & ALL CONSTRUCTION SHA'~' TNE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENE~Y~ ,,,. , ~ ~,. SUFFOLK CDUNT'Y. N '¢ SOU',r~OLb 2008-10-14 15;15 REScheck Software Version 4.2.0 Compliance Certificate P 1/1 Project Title: CARSON STUDIO Energy Code; Location; Consi~uctJ~n Type; Heating Type; 2007 New York Energy Co~ervodon Com~tmetlon Code Suffolk County, New York Detaohed I or 2 Family No~-El~'trl= GIBZing Ama Percentage: ~/e Heating Degree Days: S7~O Construction Site: 1865 WESTPHALIA RD MATTITUCK, NY 11952 Owner/Agent; LORI CARSON 1885 WESTPHALIA RD, MATTITUCK, NY 119S2 631 -Z98~5463 Complines: '13.7% Bett~r Than Code III Maximum UA; ~Ba Your UA; ~ Deslgne¢/Comractor: MERYL KRAMER MERYL KRAMER ARCHITECT PO BOX 683 QREENPORT, NY 11944 631-477-8738 MERY!-~MKARCHITECT.COM Wall 1: Wood Frame, 16' c.c. Window 1: Wo~d Frame;Doubla Pans Deer 1; Solid Wall 2: Wo~l Frame. t6" o.c. Wall :3: Wood Frame, 16' o,=. Wall 4; Wood Frame, 16' o.=. Dm3¢ 2; Gtesa Ceiling 1: CalheOral ~eiling (~ a6ic) 143 19,0 1.O 7 10 0.470 8 16 0,330 5 143 10.0 1.0 9 143 19.0 1.0 9 143 19.0 1.0 6 39 0.460 18 309 30.0 1,0 10 The proposed building represented In this document is consl~e~ ~ ~e ~ildlng pla~, i~[floa~nl, and ~er ~ this pe~lt applJ~. ~e pm~sed I~s h~l ~ ~gn~ ~ ~ ~e ~7 ~ YO~ Enemy C~ C~ r~u~. ~efl a R~s~ ~lgn ~[onal h~ ~m~ a~ sig~ ~ ~ge, ~ey am a~s~ng that kn~led~r bel~, and ~slonel Judg~L ~ ~ans or ~ti~s am In ~ t~l Title: CARSON STUDIO RalX~ date; 10114~18 fllename: C:~)o~umenta end SeaingaV~dl Uaem~Do~urr~n~ROJECT AF~CHIV~CA3RSON;CAIRSON RES CHECKrck Page 1 of 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20 Approved Disapproved a/c ,20 Expiration ., 20 PERMIT NO. BUILDING PERMIT APPLICATION 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 Flood Permit Storm-Water Assessment Form Contact: Mailto: Phone: Building inspector APPLICATION FOR BUILDING PERMIT Date t~W"T "/ 20 O~ 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 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. 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 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. (Signature of applicant or name, if a corporation) (M~iling ad~e~s'o~p~licant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nme of own~ of premises (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. Plumbers LicenseNo. ElectficiansLicenseNo. Other Trade's License No. I. Loca.tion of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Block I Lot Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:' . a. Existing use and occupancy ~'~[[q(-~L~.- ~'tl~,/~[[~( b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear .Depth 10. Date of Purchase Name of Former Owner 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__ 14. Names of Owner ofpEemises LORI ~_.,,~ Name of Architect Name of Contractor Address ~6 WF~bTt:~cPrLb~Phone No. Address fO ~ ~1'2),.~)1S~No Address Phone No. NO 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * 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. NO ~ 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__ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) , SS: COUNTY [,- v~ id. I ~ I~..(~ I~./ being duly swum, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH (S)He is the (Contractor, Agent, Corporate Officer, etc.) Oualifi~d~!u' umooa~aUin Sa~k g0unt~ Commission Ev~0ims April 14, 20 ~'~ 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 tree 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. Swum to before me this , Notary Public Signature of Applicant 1 NE CARSON BARN FLOOR PLAN NEW SLIDING DOORS TO REPLACE EXISTING WINDOW - ~-- NEW 2 X 4 PARTIAL HGT I PARTITION WALL STORAGE ROI ~M N HEATER ALL CONSTRUCTION SHALL MEET THE REQU[REi~ENTS OF THE OCCUPANCY OR CODES OF NEW YOEK STATE. ' ~1 ~s,.~,, ua IS UNLAWFUL _~(,,~ -r CERTiFiCATE EXISTING WD FRAME WALL CONSTRUCTION -- NEW FIBERGLASS BATr INSULATION IN EXISTING UNDERWRITERS CERTIFICATE REQUIRED WALLS AND CEILING NEW WlNDOWTO A?PROV. ED AS NOTED REPLACE EXISTING.,.,/ ~/~.~2 DATE:~ ~,P, #..-.,'7 c/ FEE: ~ ~/' ~- - NOTIFY BUiLDi!': L:-2~RTMENT AT 765-1602 8A",~ TO 4F:M FOR THE FOLLOWING 1, F©UNDA'fiON - TWO REQUIRED FOR POURED CO~:CREfE 2. ROUGH - FRAMING & PLUMBING EX ST NG D ~ C~ ON MUST BE COMPLETE ~O~ C.O. ALL CONSTRUCTIO~ SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. M E R Y L K R A M £ R a r c h i t e c t