HomeMy WebLinkAbout33109-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33586 Date: 03/10/09
T~IS CERTIFIES that the building ACCESSORY
Location of Propez~y: 765 WESTVIEW DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Ta3~ Map No. 473889 Section 139 Block 1 Lot 20.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 23, 2007 pursuant to which
Building Permit No. 33109-Z dated JUNE 6, 2007
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 ACCESSORY GAZEBO AS APPLIED FOR.
The certificate is issued to ARTHUR & BETSY STRAUSS
(OWNER)
of the aforesaid building.
SUFFOLK CO~N~I~fDEP;%RT~ENT OF f~A~TEAPPROV~J~ N/A
ELEC~%RIC~_L CERTIFICA~ NO. 3015042 08/06/07
PLUMBERS um~TIFICATION DATED N/A
Rev. 1/81
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
PLATINUM EAST ELECTRIC
1320 KENNEY'S RD
SOUTHOLD, NY 11971,
MR / MRS STRAUSS
765 WESTVIEW DR
MATTITUCK, NY 11952
Located at
765 WESTVIEW DR MATTITUCK, NY 11952
Application Number: 3015042
Certificate Number: 3015042
Section: Block: Lot: Building Permit: BDC: ns11
Described as a occupancy, wherein the premises e ectrical system consisting of
electrical devices and wiring, described be~ted in/on the premises at:
Basement, First Floor, Second Flo~Attached Garage, Outside, Attic, Porch/Deck,
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 6th Day of August, 200'7.
Name QTY Rate Rating Circuit Type
Service Disconnect: I 300 cb
Meters: 1
seal
3 of 3
This cer[ificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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. 33109 Z Date JUNE 6, 2007
Permission is hereby granted to:
A & B STRAUSS
765 WESTVIEW DR
MATTITUCK, NY 11952
for :
CONSTRUCTION OF AN ACCESSORY GAZEBO AS APPLIED FOR
at premises located at 765 WESTVIEW DR MATTITUCK
County Tax Map No. 473889 Section 139 Block 0001 Lot No. 020.001
pursuant to application dated MAY 23, 2007 and approved by the
Building Inspector to expire on DECEMBER 6, 2008.
Fee $ 100.00
-Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
DATE
INSPECTOR
FIELD I~S?ECTION REPORT I DATE I COMMENTS
~O,~AT~O~ ~ST~
FO~DATION (2~)
ROUGH F~G &
PL~G
~S~ATION PER N. Y.
STATE ENERGY CODE
F~
~DITION~ COUNTS
T W :C--hi:
O N OF SOUTHOLDE~{
BUILDING DEPARTM~I ¥ Z a ~ icl
TOWN HALL ~
SOUTHOLD. N ~
~ Y 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
~w. northfork.ne~Southol~ PE~IT 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
Examined ~ ,20 (9 ~ Contact:
Approved ~/ 6,20 t")~ Mailto:
Disapproved a/c
Expiration bf~ , 20° ~'
Butld:ng Inspector
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date I~ ~,x/ 7~- q ,20 O7
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
prc;perty 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.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCL;-'ANCY
('Signature of: applicant or name, if a corporation)
(Mailin~ address of applicant) /~
State whether applicant is owner, lessee, agent, architect, engineer, general col0g_~Cr~.e-dectri-ci,~n-nlumber or builder
(As on the tax rol~
If applicant is a co~oration, si~ature ofdul~authod~d ~fic~r FOLLOWIN¢ i:.: 5:
ALL CO~*~t
(Name and title of corpo~'f~L~r_~E; ~l ~.~.~_~?ME
CODES OF k.~ ~o~K ~ k~ :.
Builders License No. ~ ~: ~- ~
Plmb~s License No.
Electricians License No.
Other Trade's License No.
Location of land on which proposed work will be done:
House Number Street
FOR POURED C('' :-E'}E
2. ROUGH F,W',..,- : ! :.'!~ ,~
3. INSULATION
4. FINAL - CO:?' ..,/riOi~ LI'JST
SE COV'CLE'~ F , C '
ALL CON:ET~L":'~ , S-l,;' . MEET THE
REQUIREME~TS (.: '~;: C05ES OF NEW
YORK STATE. NCr R: ~ ;CNStBLE FOR
DESIGN OR CO~S;RUOTiON ERRORS.
Hamlet
County Tax Map No. 1000 ~ection ~ ~ c~. OlD
Subdivision
(Name)
Block CM..0~ Lot '2_{::h. I
Filed Map No.
2. State existing use and occupancy of premises and intended use and occul~ahcy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy_
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4.
Addition Alteration
OtherWork i,7_'~ v'c' 0_=A:z~ ~ch
/
Estimated
Cost ~ [~
If dwelling, number of dwelling units
If garage, number of cars
(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. ~tJ/tt~,
7. Dimensions of existing structures, if any: Front t,O/gk Rear
Height ¢,t.)('~,~ Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth VD [~ Height t,o ('~, Number of Stories
10. Date of Purchase
Dimensions of entire new construction: Front I'Z* ~ V'e_' o6~', Rear
Height ~ [ItN Number of Stories ~t~/t~
Sizeoflot: Front q%7q Rear /.Sq. a~'
Rear
Depth
Name of Former Owner
1 I. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES
13. Will lot be re-graded? YES NO i,,~ill excess fill be removed from premises? YES
NO t,,,/
14. Names of Owner ofpremises~Address ~',,~ ~t,,,,~?r~ to{ Phone No.
Name of Architect Address Phone No
Name of Contractor/,/~,~,~.lp,~s t,~_.%,~c Address ~hone No.~
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ~/'~O
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS M/AY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distanCbs't0 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 i/--
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
CO TY or&XCe :
· ~1~ ¢~ "u-I kO~e~-Jc°w~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above name& :~
(S)He is the
(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 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.
Sworn to before me this
,(y~d..~.-I"C--day of M ~ 20 o '"[
Nota~.l~
No. O~ ~Ot ~
Si-g~ature of Applican(
Erosion, Sedimentation and Storm-water Eun-off Control Plan ASSESSMENT FOEM
Yes No
EXEMPTIONS:
A. Does this project meet the mini~num standards for classification as an Agricultural Project. - ~,~1
Note: If you answered Yes to any of the above, a Storm.water, Grading, Drainage & Erosion Control Plan is not required.
ACTIONS REQUIRING THE SUBMISSION OF A STORM~WATER~ GRADING~ DRAINAGE & EROSION
CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
Item Number: (A Check Mark (,/) for each question is required for complete application)
Will this project retain all Storm-Water Run-off generated on Site?
(This will include all mn-off created by site clearing and/or construction activities as well as all
Site Improvements and the permanent creation of impervious surfaces.)
Will this project require any land tilling, grading or excavation where there is a change to the
natural existing grade involving more than 200 cubic yards of material within any parcel?
Will this application require land disturbing activities encompassing an area
of five thousand (5,000) square feet of ground surface or more?
Is there a Natural Water course running through the site or is this project within
One hundred (100) feet'of wetlands or a beach?
Yes No
Will there be site preparation on slopes which exceed fifteen (15) feet of vertical rise to
One hundred (100) feet of horizontal distance?
Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off
into and/or in the direction of a Town Right-of-Way?
work sill be performed in the manner set forth in the application filed herewith.
Sworn to before me this;
.......... ................... ,Oy ..................... 20.0.7
Notary Pubhc(J.~ .K,<~A~xc .....NOT/*R¥ $~ffi.tO. 8~I~.~.N~ Y~
~' (S~t~}~' o; X;~licant) .............
7. Will this application require the placement of material, removal of vegetation and/or the
.construction of any item within the Town Right-of-Way or road shoulder area?
(lhis item does not include the installation of driveway aprons.)
. Will there be site preparation within the one hundred (100) year floodplain of any watercourse?
8.
Note: If any answer to questions ~ne through eight is answered with a check mark In the Box, a Storm-water, Grading,
Drainage & Erosion Control Plan is required and must be submitted for review prior to issuance of any building permit,
STATE OF NEW YORK, ~ ff'f
\COUNTY OF l~ .......... SS
........... be dnlyswom, a pose, and says that e she is the applicant Pe=t,
~Nan~e of individual {igning Document)
And that He'he is the...' ..........................
(Owner, Convractor, Agent, Cmporate Officer, etc.)
Owner and/or representative of the Owner or Owner's, and is duly authorized to perform or have performed the said work and to make
and file this application; that all statements contained in this application are true to the best of his knowledge and belier; and that the
The locations o! wells and cesspools
shown hereon are from field observe/lens
and or from dda ofitdne, from other$.
DwE;LLiNG
Oi~IVE~
~ 18 C.P.
SCDHS REF. # R/0-05-005/
BRoWERY RD,_._.
ANY AL TERA T/ON DI~ ADDITION TO THIS SURVEY
OF SECT/ON XH09 OF THE NEW ¥O~K STATE EDUCA770N
S~/O ~P ~ C~ 8~ THE ~ ~L
WHOSE ~ TURE APP~$ H~E~
ADDITJ~LL Y TO C~L Y MTH ~ ~
I om f~m#lar with Ihe STANDARDS FOR APPROVAL
AND CONSTRUCT/ON OF SUBSURFACE'SEWAgE
DISPOSAL SYSTEMS FOR SINGLE FAME_ Y RE$1DETqCE$
end w/I~ abide by /he condllons sel forlh Ihere~ eil?l ~f ~f~e
permil 1o condrud.
."'J'"'"' -' SURVEY OF PROPERTY
~°~"~? . A T MA TT/T~ICN
i ... .~- TOWN ,OF SOUTHOLD
~ -- SUFFOLK CO~NTY,.N K
· ,o' ~' 1000 - 139 - 01 ~ 20.
1
SCALE.. 1" = 40'
MARCH. 5, 2003
APRIL 16~ 20Q$ ~ TOFO.
-~, /~ , ~
,-_~ Od/: I!, 200q (c~tlflC~tlon~
7°
FLOOD ZONES FROM FIRM
~6103C0481 G 514198
Dork brown
loom OL
Brown olffy
PoI~ brown
fine lo coerse
SW
Pole ~rown
8ne lo medium
SP
Woler In pole
s~l SP
CERTIFIED TO'
NORTH FORK BANK
SOUTHOLD~
~.Y.& LIC. NO. 49618
ER'QS,P.C,
Y'FAX (631) 765 - 1797
STREET ~
N.Y. 11971
AREA = 50,176 sq. ft to tie line
ELEVATIONS & CONTOUR LINES ARE
RE~ERENCED TO N.G. V.D.
FLOAT
03- 127 "'