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Home My WebLink About36075-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34750 Date: 12/17/10 THIS CERTIFIES that the building DECK ADDITION Location of Property: 2000 PIKE ST MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 140 Block 3 Lot 21 Subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 29, 2010 pursuant to which Building Permit No. 36075-Z dated DECEMBER 6, 2010 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" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & DONNA TANDY ( OWNER ) of the aforesaid building. SUFFOLK COU~FI"f DEPARTMENT OF HEALTH APPROV]kL ELECTRICAL c~KTIFICATE NO. PLUMB~ c~KTIFIC3%TION DA'r~u3 Rev. 1/81 N/A ~/A N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 36075 Z Date DECEMBER 6, 2010 Permission is hereby granted to: JOHN & DONNA TAIl-DY PO BOX 1208 MATTITUCK,NY 11952 for : "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 140 pursuant to application dated NOVEMBER Building Inspector to expire on JUNE 2000 PIKE ST MATTITUCK Block 0003 Lot NO. 021 29, 2010 and approved by the 6, 2012. Fee $ 862.40 ~uth~z~nature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. 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 form). 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 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6.Submit Pl.a~ing 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: 1. 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 1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre--existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New ConstrUction: Old or Pre-existing Building: (check one) Location of ProPerty: ~./_-,f>£~9 ~1'~ ~t'~ ~ ~ C~ House No. Street Hamlet Own~orOwne~ofPrope~y:~ ~ ~ ~~ ~~ Suffolk Co~ T~ Map No 1000, S~tion ~ ~ O Block ~ ~t ~ ~ Sub~h~ion Filed Map. ~t: Pe~it No.-~ ~ ~ Date ofeemit, i ~ [ ~ Health Dept. Approval: 'Planning Board Approval: Applicant: Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ ~) I~) · ~-- Final Certificate: (check on, e) ure TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ [ ] ROUGH PLBG. [ [ ] INS~JLATION [ [/.~IAL [ [ ] RRES~:E'rY.~SPEc'no~ [ ] RRE RESISTANT COIiSTRUCTI0fl [ ] RRE RESISTANT PENETRATI0fl REMARKS: d~'~~T INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 S outholdTown. NorthFork.net Examined Approved /~..'/~, 20 Disapproved a/c Expiration 0]6,20 i40V 2 9 ' BLDG. DEPI. PERMIT NO. 9 ¢o75-- 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 to: Phone: ,PPLICATION FOR BUILDING PERMIT Date //- ,9, e:=/ ., 20/o INSTRUCTIONS pletely 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 promises 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. fi 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, Suftblk 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,~~~ltousing c~nd,~e,4~ulations and to admit authorized inspectors on premises and in building for necessary inspections. (~natur"e-of applicant off. Ill'e, ifa corporation) State~heofhsrlpplFt~cant is owner, ,essee,~, architect, (Mailing address of applicant) engineer, general contractor, electrician, plumber or builder Nameofownerofpremises '~n ~,'"~l"r4.~x7 4~ (As on'the tax If applicant is a corporation, signature of duly authorized officer roll or latest deed) (Name and titleot¥c0rporate officer) Builders Lhtcme Nm.. ,-., ,.i,:., Plumbers Li~effse No: ~""' ' Electricians License No. Other Trade's License No. 1. Location ofl~nd on~ which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section J~o~ o o Block ~3. o c~ Subdivision Lot o'Z!. c~oo 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 ~ ~¢ ~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost ~ r_,~o - 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 7. Dimensions of existing structures, if any: Front ~ ~o~-~ Rear Height. Number of Stories / .,~//0 Dimensions of same structure with alterations or additions: Front Depth. Height. If business, commercial or mixed occupancy, specify nature and extent of each type of use. "-' ~' .,l.~ Depth ~ ~ Number of Stories Rear 8. Dimensions of entire new construction: Front Rear .Depth Height Number of Stories 9. Size of lot: Front /~o Rear ~O 10. DateofPurchase ]~c~"7 Name ofFormer Owner xJ"-'~]~,/::J.~'-~/,,,~7~/,,~rJ /'~.'""~.,z),~ 1 I. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO l,,/ 13. Will lot be re-graded? YES__ NO /,~ill excess fill be removed from premises? YES NO ~ 14. Names of Owner ofpre~mises~],,~ /~-'J-'F4~ Address 2~0 NameofArchitect /%/,S~-/.. /,Oill/,~5o, o" Address,0,x Name of Contractort~J~t~g "Z,,gA~r,~- Address/Go~ tOjg',x ~)- Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a fi-eshwater 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 t/ * 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) SS: COUNTY OF~,~5t'~' ) ( 4~t"~O'-7 being duly sworn, deposes and says that (s)he is the applicant (Name of iq~ividuaI sigfiing contract) above named, OOl~ll~ D, BUNOH (S)He is the ~ ~.._l~.8~t~.o~,~w ¥o~ (Contractor, Agent, Corporate Officer, etc.) ~'l~Ooant~/ .:, ~ Oc~nlee~ ~ Ap~ 14, 2_~Z ers~id o~vner ~, and is duly authorized to perfo~ or have pertb~ed the said work and to make and file this application; that all statements contained in this application are tree to the best ofhi~ ~owledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 9)C44x dayof lxJo~.~.~Ii~.~ 20 iL) Notary Public TOWn of Southold SedimentatiOn & S orm-- a ESSMENT FOR,- LOCATZOH: S.=T~ THEFO~O~NGA~ONSMAY~Ui~ESUB,~.~NO, ~ · 3 ~ I .~TO~WATE~ 6~ D~NAGE ~D ER~mN ~-~-~O' ~ ~)n~mm~ MIh IM ien~ asd WJ M If~ penal In ~,~,~ k ihe ~M)F~ M~ll FORM - 06110 6 Is them a Natural Water Co~e Running through.the Site? Is Inls ProJec~ wi~in ~'~e Trustees ju~d~ct~t or within One Hundred (1 Off) feet of a We~and or Beach? 7 Will'there be Site praparaUon on FgdsUng Grade Slopes which Exceed FJ~een (15) feet of VerUcal Rise tu One Hundred (100') of Horizontal DistaqCe? 8 Will Driveways, Parking Areas or othe~ Impen/~ous Surfaces be Sloped to Direct StomvWater Run-Off Into and/or In the direction of a Town dghrof-way? 9 wm u~ Proleet Requim.ine ;~=ememdMaten~ 'Rembval °f veaeta~n and/°r the ~ of'anY ~tem Wl~n the Town R]g~-ef-Way or Road $1x~dder 5 Will this ApplicaUon Require ~and Disturbing Ac~'ities r'~ Encompassing an ,Nea in Excess of Five Thousand (5,000 'S.F.) Square Feet o~ Ground Surface? ' . TOW~ OF · CO. CLK. NO · SUFFOLK COUNTY N.~ FILED FILE SURVEYED <~-.'7- "'~,, 19 9,:9' BY RAMPART SURVEYING P.C. P/O BOX 34O EAST MORICHES,. El., N.Y. 11940 Ex~sting Residence IBL H~' Ouu,u: ANC~ OR I ':"' UNLAWFUL PLAN '' 'ii' £ERTIFIC~ ~ ~.~ AFPROVED A8 NOTED t ~L~L BUILDING DF¢c rMEN' 5-1802 8 AM TO 4 uM FOR FOUNDATION - TWO ~ JhIRED FOR POURED CONC, F~L; E ROUGH - FRAMfNG. PLUMBIN' STRAPPING, ELECTRICAL & INSULATION FINAL- CONSTRUCTION & E.ECTRIgl MUST BE COMPLETE FOR C O L CONSTRUCTION SHALL MEET TNE QMIREMENTS OF THE CODES OF NEW ,RK STATE NOT RESPONSIBLE FOR SIGN OR CONSTRUCTION ERRORS RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTEB 236 OF THE TOWN CODE. /.._AS-BUILT DECK ) 5?8 ~ ~j. TANDY ~ 2000 PIKE STREET MA]-rlTUCK N.¥ 11952 ~..~_o~ -4'k4" A¢~. i~O_Sl?-s. 2010 $6,&L.g ~" = L2 SECTION