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Home My WebLink About33833-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33464 Date: 12/23/08 THIS CERTIFIES that the building ALTEP~ATIONS I~)cation of Property: 3770 WICYd~AM AVE (HOUSE NO.) (STREET) Co%mty Tax Map No. 473889 Section 107 Block 9 Subdivision Filed Map NO. Lot No. __ MATTITUCK Lot 18 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 2008 pursuant to which Building Permit No. 33833-Z dated APRIL 18, 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 ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN F & AMY M ELLIOTT (OWNER) of the aforesaid building. S~3FFOLKCX)L~YDEPAR~ENT OFH~%L~"dAPPRO%FAL N/A EL~t-rKICAL U~K'rIFICATH NO. 4012400 12/15/08 ~L~ERS CERTIFICATION ~A'£~u3 12/08/08 PERFECTION PLUMBING ~rized Signature Rev. 1/81 TO~'~ ~L UuDG. DEPT. 765-1802 L TQ_WN 0 F _S_~.O' APPLICATION FOR CERTIFICATE OF OCC~cy ~s appli~tion must be fill~ in by t~ewrit~ or ~ ~d sub~tt~ to ~e Buildi~ D~t ~ For new bu~ding or new use: wi~ ~e followi~: 1. Fi~l su~cy ofprop~y with 'a~urate io~tion of~l buildi~s, prepay lin~, s~, ~d ~1 nat~ or /o~c f~. 2. Fi~I ~pro~l ~m H~I~ D~i. ofwat~ ~upply and sew~g~sposal (S-9 fo~). · 3. ~rov~ of ciVil im~llation ~om Bo~d of Fire Unde~fit~. 4. 8wom s~tem~t ~m plumber ~i~ng that ~e solder ~.in syzt~ ~ l~s ~n ~10 of 1% l~d 5. Co~ial building, indust~a/building, multiple r~iden~ aM si~lar buildings and insulations, a ~fi~te of Code ~liance from archit~t or engin~r r~pousible for ~e building. 6. Submit Pla~ng Board Approval of~mplet~ site plau r~uirem~ts. B. For existing buildings ~rior to April 9, 1957) nou-conformlag us~, or buildings and "pre-existing,, laaduses: 1.Accurate ~mey of property showing all prop~y lineS, struts, building and uuusual uatural or topographic f~tures. 2. A properly complet~ application and consent to ins )~t s'~ by fl~e ap ~li~nt. Ifa Cm~ifi~te of Occupmcy dmfi~, the Building Inspecto shall state the r~so ~s there~r in writing to the applicant. C. Fees i. Ce~ifi~te ofOccupaocy _ New dwelling $25.00, Additions to dwelling $25.00, ~teratious to dwelling $25.00, Swiping pool $25.00, Acc~so~ buildiug $25.00. Additim~ to a~sso~T building $25.00, Businesses 2. Ce~Xifi~te of Occupancy oo Pre-existing Building. $100.00 3. Copy of Ce~ifi~teofO~upancy_ $.25 4. Updat~Cenifi~teofOccupancy_ $50.00 5. Temporary Cmxifi~te of Occupancy _ Residential $15.00, Con~ercial $15.00 Hew Const~tion: _ _ Old or Pre-existing Building: _ ~ ~ _ (ch~k one) House No. 8tree~ ~ . ~er or Ownen of Pmp~y: Ha~et )"ffolk C~unty T~ Map No 1000, S~tion ~ Block ~ ~ ~t ~ _ Appli~nt: [~lth Dept. Approval: Unde~ritcn Approval: l~ng Board Approval: ~uest for: Te~ora~ Ce~ificate ~ Final Certificate: ~ Sub~tt~: $ ~ ~ ~ o ~_ (ch~ck one) 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 G & S ELECTRICAL CONTR. AMY & JOHN ELLIOT P.O. BOX 215 3770 WlCKHAM AVE SOUTHOLD, NY 11971, MATTITUCK, NY 11952 Located at 3770 WICKHAM AVE MATTITUCK, NY 11952 Application Number: 40'12400 Certificate Number: 4012400 Section: Block: Lot: Building Permit: 33833 BDC: ns11 Residential 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, Second Floor, 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 lSth Day of December, 2008. Name QTY Rate Rating Circuits Type AdditionalCharges kitchen den-2nd floor bathroom Appliances and Accessories Dish Washer 2 0 1.2 KW Exhaust Fan 2 0 F.H.P Wiring And Devices Dimmer 6 0 120 V Fixture 22 0 Incandescent Outlet 22 0 Fixture Outlet 23 0 Gen, Purpose Receptacle 5 0 GFCI Receptacle 12 0 Gert, Purpose Switch 12 0 Gen, Purpose seal I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. TOWN OF SOUTIIOLD OFFICF. OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Building Permit NO. 3~5 . ow.er ~'~k,~ Ffl,o"r (please prin~) (please ~ r ~ I certify that the solder used in the water supply system contains less thau 2/10 of 1% lead. (plumber'S signature) S%~orn to before me this ....... day of ......... Notary Public, __~_b_{ .... County Notary Public VICKI TOTH Notary Public. State of New York No. 01T06190696 O. ua fled n Suffolk County Commission Expires July 28, 20 I~.._~ 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. 33833 Z Date APRIL 18, 2008 Permission is hereby granted to: JOHN F ELLIOTT 3770 WICKHAM AV MATTITUCK,NY 11952 for : ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 3770 County Tax Map No. 473889 Section 107 pursuant to application dated APRIL WICKHAM AVE MATTITUCK Block 0009 Lot No. 018 11, 2008 and approved by the Building Inspector to expire on OCTOBER 18, 2009. ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION ~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~INSULATION [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: 33~3 7. ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST ~)~ROUGH PLBG. ] [ ]INSULATION [ ] FINAL FIRE SAFETY INSPECTION [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT PENETRATION [ ] FIRE RESISTANT CONSTRUCTION [ ] REMARKS: ./~-/~~' ~ ~~~.~~_ DATE ~'~ '~-'0 ~ INSPECTOR En;LD r~S?~CT~O~m'ORT I DxrE [ CO~XS ~& ] FO~ATION (1ST) ~ ~ PL~G ~ q [NSUL.~I iON PER N.Y. ~ STATE ENERGY CODE ~DITION~ COUNTS ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 · FAX: (631) 765-9502 SoutholdTown.NorthFork.net Approved ,20 Disapproved a/c 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: Mail t O:/~r~S~ Phone: APPLICATi'ON FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be cbmpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of ~'~s; accurate plot Pi~n to-'~cale. 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. Thereafier, 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 onpremises and in building f or necessary inspections. ~~7~(Sig~ature ofapplica~n~rname, ifa corporation) ¢32 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises 3~b~J dd/~9" ~-~(~/~/'7-~- t (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 License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision Io7 Block ~ ~ Filed Map No. Lot //~ Lot 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 ~J'",~r'~__. 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 Addition Other Work Fee Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business,~,~_mm~.[cial or mixed ,~l_,o~cufEancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height_ Number of Stories 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 9. SizeofIot: Front Rear Depth Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated .t~2 '~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO/ 13. Will lot be re-graded? YES NU Will excess fill be removed from premises? YES __ NO__ 14. Names of Owner ofpr,ep~a, ises at,Ct at7'- Address Phone No. ~7- J'~.J NameofArchitect ,/~,~'~: ~O%.,-,fz'/F'-~ Address PhoneNo 7..,~- ~[~- Name of Contractor Address Phone No. 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 ora 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. 1 7. If elevation at any point on property is at 1 0 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) C OUN~TY OS-O ~t~5)S: ~/~f,t~~(('4'"'"~~'~ t~'~' being duly sworn, deposes and says that (s)he is the applicant (Name of individual' signing contract) above named, (S)He is the · (Contralto[, Agen~ C¢orporatte 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 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. '' ' Not~i'y u~ic MELAN E DOROSK ~ ,, r ~uuk~u, Sta e 07 ~ew York Szgnature of ~n~licant No, 01DO463,t870 Qualified in Su~f0Jk County ,, . l 0 Commission Expires September 30, ~--~-~_ TOWN OF SOUTHOLD PROPERTY RECORD CARD FOmER'0WhER q N E anl~ ~10 s~. vL ~,m C~M. CB. MISC. Mkt. Value MND IMP. TOTAL DATE R~ AGE BUILDING CONDITION ~ ~~ ~ N~ NOeL ~ELOW ASOW ~. * ~ ~ FA~ Acm Value Per Value t ~ ~_ ~ d rillebl~ 2 I · Fillo~l~ 3 ,,, q~la~ i~mpl~d FRONTAGE ON WA~R ~rushla~ FRONTAGE ON ROAD C ~ ~ BULKH~ '~al ~K ~ctension ~ension xtension arch arch 3reezewoy ~r~ge Potio ;'oral ~?° COLOR TRIM Foundation Ext. Walls Fire Place Fype Roof Recreation Room Dormer Driveway Both / Floors Interior Finish 4eat /t~, ~../. Rooms 1st Floor Rooms 2nd FIool Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: e,C.T.H, #: Item Number: (NOTE: A Check Mark (,~) for each Question is Required for a Complele Application) Will this Project Relain All S[orm-Waler RumOff Generated by a Two (2") Inch Rainfall on Site? (This item will include all rumoff creeled by site clearing end/er construction activities as wall as all Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shaft include all Proposed Grade Changes and Slopes Controlling Surface WaterFIowl 1 2 3 4 5 6 7 8 THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION CFA STORM-WATER, GRADINGI DRAIHAGE AND EROSION COHTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF N~W YORK, Yes No Will (his Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade InvoMng more than 200 Cubic Yards of Me edal within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Sur[ace? Is there a Natural Water Course Running through the Site? Is this Project within the Trustees udsdiction or within One Hundred (100') feet of a We land or Beach? Win there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet ct" Vedical Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other Impervious Sur[aces be Sloped to Direct Storm-Water RumOtf into and/or in the direction of a Town dghEoPway? 9 Will this Project Require the Placemenl of Material, Removal of Vegeta[ion and/or the Construction of any bern wigan Ihe Town Right-of-Way or Road Shoulder Area? (This item will NOT include the tnstallation of DriYeway Aprons.) Will this Project Require Site PleparaUon wilhin the One Hundred (10g) Year Ftoodplain of any Watercoume? NOTE: IfAnyAnswertoQuestionsOnethroughNineisAnsweredwithaCheckMarkintheBox, aStorm-Water Grading Drainage & Erosion Control Plan is Required and Must be Submitled for Review Prior to Issuance of Any Building Permit! EXEMPTION: Does this project meet the minimum slandards for c ass fica on as an Agdcu[lural Project? Note: If You Answered Yes to this Question, aStorm-Water, Grading Drainage&ErosionContro P an is NOT Requiredl m~e and file dus app[icaOon; d~al MI smtcnmnt.s con~ucd m fl~is appl~catJou am a'uc to fl~e l)est of his ~]owiedgc and [)did; and d~at d~e woik ~mll J)e perfurmed iu die mann(e* set foH]~ ii~ thc applicatiou filed FORM - O6/~7 NOTARY PUBLIC, State of NewYgrk No, 01D04634870 Qualified in Suff0Ik County -.,^; ~ 6grnmissi0g Expires September 30, ~.._r, ,. Yes No -i LOTS SURVEY OF 1, 2, P/'O 3 & P/O .4MF, NDED MAP OF MATT[TUCK HEIGHTS FILE No. lt84 FILED JULY 24. 1955 SITUATED AT MaTTITUCK TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK s.c. TAX bio. 1000-107-09-18 SCALE 1"=30' JANUARY 25, 2005 4 CER?~FIED TO COMMONWEALTH lAND TITLE INSURANCE COMPANY LEHMAN BROIHERS BANK JOHN ELLIOT AMY ELLIOT NOTE ADDITIONAL STRUCIURES tF ANY ARE NOT SHOWN DUE TO SNOW COVER ON DATE OF SURVEY. .~r. Ingegno Surveyor APPJ~OVE~ AS NOTED 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWC REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION 4, FINAL - COR"'rqUgTION MUST BE COMPLETS ~OR C O, ALL CONSTRUCTION SNALL MEET THE REQUIREMENTS OF THE- CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUOTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND C2Nu'TIONS OF ~, b4~___ SOUT~!O'-C' T(:',"' 7BA SO'J-,'f'J Tq','.'h -..'~.I,!~I~G BOARD ,! N.YS, DEC OCCUPANCYOR USEIS UNLAWFUL WITHOUT CERTIFICATE OFOCCUPANCY PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF QCCUPANC Y SOLDER USED IN WATER SUPPLY S YS TEM CA NNOT EXCEED 2/10 OF 1% LEAD. COMPLy WITH CHA"PTER" · FLCOD DAM 46 soumo, r, ~5..q~yREVENTION "'~' ~WN CODE. PL.UMBIN~I ALL PLUMEIN(~ WA§T~ & WATER LiNg§ T~E~TING BEFORe. : UNDER~RSCERTIFICA~ CERTIFICATION OR NAILING & CONNECTION8 REQU!RED ALL CONSTRucTION SHALL MEET THE REQUIREMENTS OF THE CODEs OF NEIN YORK STATE. F0'EE- BA---~'~M ENT EXIST. dONE, PbOdK ~PN WA-b5 ( C m ED(IS'T, ~L SPACE L FOUNDATION PLAN 1/4"= 1 '-0" EXIST. EXIST. EXIST, II ~W 2~8 R,R...._,. / ~16~ 0,¢, / __ I EXZST, iql I I~ III N~W 2~ R.R. ~) WCr'~lO W/¢ 2) 2~ P~'"WC~N UNIf5 2 ~,=R~,SJ FLOOR PLAN \ \ FRAME GARAGE PLOT PLAN 1 "= 30"O" - ~¢~l/4II 5~.~b ¢ObUMN POWDER RM INTERIOR ELEVATION 1/2"= 1 '-0" JOI.~HAN~R 2M Pb, P,J, ~OUKINO KITCHEN BEAM DETAIL 1/2"= 1'-0" REVISIONS U.I DRAWN: .)G SCALE: AS NOTED 3OB #: ~,PPAL 4, 2008 SHEET NUMBER: A REVISIONS ~ [ X__,__, " ' I I r ~ '~ II II r- .... I I EXIST, / ~ ! ¢' I I ~ II II I- .... ,, II II ., ~ ~ ~ ,, ,I , ..... , Z I N×IS~IN~ HfCH ] i i -~ ,, H J-t '~___ - 4: I I ~ ~ ~ ~=~ -~ =- ~ ........ ,, .,¢ .... < ~ ~ m 0 D~WN: 3G ~ .%~, S~LE: 1/4"=~'-0" ~ ¢ AP~L 4, 2808 m 1/4,,=1,.o,' 1/4"=1'-0" "(~m'i'"' ' ' ¢- I ~TH ELEVATION PIN, ~'~ WEST ELEVATION 1/4"= 1 '-0" 2nd PI., PIN, 2dPb PIN PLO01~ ~H ELEVATION ~ ELEVATION REVISIONS 0 ILl DRAWN: SCALE: 1/4"= 1'-0" ]OB #: APP.[L 4, 2008 SHEET NUMBER: A-3