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Home My WebLink About34168-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 4/8/2011 CERTIFICATE OF OCCUPANCY No: 34889 THIS CERTIFIES that the building Location of Property: Date: RESIDENTIAL ALTERATION 4/8/2011 1200 THERESA DR MATTITUCK, N.Y. 11952, SCTM #: 473889 Sec/Block/Lot: 115.-13-14 Subdivision: Filed Map No. conforms substantially to thc Application for Building Permit heretofore 9/15/2008 pursuant to which Building Permit No. 34168 was issued, and conforms to all of the requirements of the applicable provisions of thc law. Thc occupancy for which this certificate is issued is: interior alterations to an existing one family dwelling as applied for. Lot No. filed in this officed dated dated 9/18/2008 The certificate is issued to Smith, Maria (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 4018286 11/24/08 Au~-~ed Sig~ure 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. 34168 Z Date SEPTEMBER 18, 2008 Permission is hereby granted to: DAVID & MARIA SMITH 1200 THERESA DRIVE MATTITUCK,NY 11952 for : INTERIOR ALTERATIONS TO A SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 1200 THERESA DR MATTITUCK County Tax Map No. 473889 Section 115 Block 0013 Lot No. 014 pursuant to application dated SEPTEMBER 15, 2008 and approved by the Building Inspector to expire on MARCH 18, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTIIOIA) BUILDING DEPARTMENT TOWN IIALL 765-1802 APPI,ICATION FOR CERTIFICATE OF OCCUPANCY This application must be Iii}cd in by typewriter or mk and submitted to the Building Department '~ ith the (ollowing: A. For new building or new nsc: 1. Final stuwey of propeffty with accurate location of all buildings, property lines, streets, and unusual natural or topographic [;ca}arcs. 2. Final Approval from Ilcallh Dept. of water snpply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Bom'd of Fire Underwriters. 4. Sworn statement l¥om plumber cemfying that the solder used in system contains less limn 2/10 of 1% lead. 5. Conmlercial building, industrial building, nmltiple residenccs and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible tbr the bnilding. 6. Submit Planning Board ApprovaloFcompletedsiteplanrequirements. ~t~ (!~ ~ B ~ ~,- B. For existing bnildings (prior to April 9, 1957) non-conforming uses, or bull I. Accurate survey of property showing all property lines, streets, buildir features. 2. A propcrly complctcd application and consent to inspect signed by the appl denied, tile Building lnsl:~Cc/or shah state the reasons there£or in writing to I C. Fees 1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $5t).00, Swinlming pool $50.00, Accessory bnilding $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificme of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. klpdaled Ceriificate of'()ccnpancy - $50.00 5. Temporary Certificate et:Occupancy - Rcsidemial $15.00, Commercial $15.00 Date. New Construction: ..... Old or Pre-existing Building: __~ ...... (check one) . }louse No. ~trcct Snflblk (oun ~ I ax Map Nt 1000, Section Subdivision Health Dept. Approval: Planning Board Approval: Requesl lbr: [ cmporary ('ertificate loc SuJm/it/ed: 5, Block 1 ~'"'~ Lot Filed Map. Lot: Applicant: (~{O.X'iCx- ~ ~-gOi¢i Final Certificate: (check one) Applicant Signature Hamlet Underwriters Approval: 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 Q.C. ELECTRIC PO BOX 518 LAUREL, NY 11948-0518, MARIA SMITH 1200 THERESA DR MATITUCK, NY 11952 Located at 1200 THERESA DR MATITUCK, NY 11952 Application Number: 40'18286 Section: Block: Lot: Certificate Number: 4018286 Building Permit: . BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, 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 24th Day of November, 2005° Nam~ OTY Rat.__~e Rating Circuits Tv~e AddifionalCharges assorted up grades on I st floor and basement Alarm and emergency equipment Sensor 2 0 Sensor 6 0 Wiring And Devices Fixture I 0 Fixture 4 0 Paddle Fan I 0 ReCeptacJe I 0 Receptacle I 0 Receptacle 1 0 Switch 2 0 0 Carbon Monoxide 0 Smoke Low Voltage 20a-laund~ Appliance 30a Dryer GFCl Gert. Purpose 1 of I seal 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 Hall Annex 54375 Main Road P.O. Box 1179 Soulhold~ New York 11971-0959 BUILDING DEPART~ TOWN OF SOUTB ~ne (631) 765-1g02 CERTIFICATION Building Permit No. ~b/] (Please print) (lSlease prin'~)' Date: I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this <ff (J day of ~a x c, [~-- , 20 t~ VICKI TOIh Notary Public.State of New York No. 01T06190696 Qualified in Suffo Comm SS/On F×pire* TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ~NSULATION ~X~FRAMING~ [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~-' DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION REMARKS: INSPECTION ~X~ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY FIRE RESISTANT CONSTRUCTION INSPECTION /~/ROU G H PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE //~ I c~ ~ ~ ~. INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765- t 802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ [ ] ROUGH PLBG. [ ] INSULATION ~' FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE 1--~° --/o INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] Fm,=REmSTJN'rCONSTR~ [ REMARKS: [ ] ROUGH PLBG. [ ] INSULATION ~X~FINAL [ ]FIRE SAFETY INSPECTION ] RRE RESBTANT ~ENETRA110N Y DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ v~' FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 'w~'~"*~:~'~ ~-~ DATE ~-~//~'*"//~ INSPECTOR ~~"~~ FOUNI)AT][ON (1ST) ROUG~ F~G & P~G ~ ~*SL~ATION PER N. , TOWN OF SOUTHOLD BUILDING DEPARJ~VIENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Disapproved a/c Expiration -3 '~ \Q0,20'~0 b,..D ~, DEPT. Building Inspector 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 Fom~ Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter er 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, Suftblk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, er 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 i~ b~fildin~for necessary inspections. COMPLY W!TH ALL CODES ~ ~_~ ,~-~ I~: o N~-UUlHED .AND CONDITIONS O~'S'gname bfapplicant or name, ifa comoration) - s0u Dr0wNzu /o 0 D SOUTHO!.D TOWN PLANNI~ ~ (Mailing addre~ of applicant) t State whether ap¢icant is own;; lessee, agenCa J, eO i ;r, ¢neral contractor, e ectrician, plumber or builder ~.¥.$. D~C "' ' "->'ecu" ~'~ '/[~ APPRQVED AS NOTED _, Nameofownerofpremises [~tCL['I6~ ~t-) id ~v~ .... O/,O/A~ .... (As on the tax roll or ~~ ' ,~ ~ If applicant is a co~oration, si~ature of duly authorized officer FEE:~O[) t O O BY: V ~-I ~[ [mnkl~V ~ NOTIFY BUILDING DE?AR~MENT AT ~e ~d title ofco~orat~F~I~ I ~ t 765-1802 8AM TO 4 PM FOR THE USE IS UNLAWFUL ~o~ow,.. ].S.ECTtO.S: Builders License No. 1. FOUNDATION - WeD REQUIRED ......... "CERTiFiCATE ~o..OU.E~ CO.C.ETE Plumbers License No. VVI I HUU I Electhcians License No. 3~& ~ ~" ~'D, &kl~V ~&~r~~UGH- FRA~t~.~ PLUMBING Other Trade s License No. ~' ~'TM~' ' ....... ~ ' ' ~ ¢ ~ ~AE; ~O~RUCTION MUST Location offal nd on which ~osed work will be doge: O ' ~.-2o q h ~ c~c,. j) r-iv o l~t&H House Number Street County Tax Map No. 1000 Section Subdivision BE COMPLETE FOR C.O. t ALL CONSTRUCTION SHALL MEET THE Block t~ Lot Iq Filed Map No. Lot State existing use and occupancy of premis.e[ and intended use and occupancy of proposed construction: a. Existing use and occupancy P-Ioflt b. Intended use and occupancy ~O~ Ca. e_~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee ~__ (To be paid on filing this application) 5. If dwelling, number of dwelling units Num~r~f~dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 1-,,1 I t2} 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 Rear Depth 9. Sizeoflot: Front Rear Depth 10. Date of Purchase NameofFormerOwnerr'~t)[J'~(~'O[3e~"~-i"'°'"[ 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 e/Will excess fill be removed from premises? YES__ NO v'/ 14. Names o f Owner o f premises ~)g'~t~'g~a; { c~O;,~Ad ares s[~50~-~xe ~'¢ ~:,..~¥'. Name of Architect Address Name of Contractor Address 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. PER:MITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? ~,YES NO ~ ~ * IF YES, D.E.C. PERMITS MAY BE REQLJI~,ED. ,!, ~ '' 16. Provide survey, to scale, with accurate fouhdation plan and di,stances to property lines. 17. If elevation at any point on property is at 10,,fe~et 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. ' :' ' ' .......... Phone No Phone No. STATE OF NEW YORK) ~O~'f ((~ being duly sworn, deposes and says that (s)he is the applicant (Nme of individual si~ing contract) above named, (S)He is the ~'~ ' (Contractor, Agent, Corpovaf~ Officer; etc.) of said owner or owners, and is duly authorized to perform or have p~rformed 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. Sworn to before me thi~ _t~_ day of '~ lt~ Notary Public 200 ' ' No. 01T06190695 '" Signature of Applicant Qualified in Suffo k County uommlssion Expires July 28, 2~ (~ Tow____ n o__f $outhold Erosion, Sedimentation & Storm.Water Run-off ASSESSMBNT FOI~M PROPERTY LOCATJON: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF/~ Item N urabgr: 1 - STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL P~ DisE'ic~ Sec(ion filock Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW {NOTE: A Check Mark (,~) for each Question is Required for a Complete Application) Yes No (This item will include all run-off crealed by site clearing and/or construction activities as well as'ali/SCte ~, .rl~/ I · I I Improvements and the permanent creation of impervious surfaces.) EXEMPTION~ Ye~s N~o Does this project meet the minimum standards for classification as an Agdcuflural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan s NOT Required! STATE OF NEV¢ YORK.~ .~.-J,~/~' ~' ~ COUNTY 0 ~ _':,,.2 .~,.. t..t ~'.,, ...................... SS Tl~at I ...... ~ ~..~~ ............ bring duly swo~ n, depos~,s ~nd says al, at he/she is fl, e app~cam fo~ Permit, &~cl thai he/she iS Ibc ~.~ Owne~ and/or representa~v¢ of tim Owner of Owner's, ~d is duly auflmrized to perform or have performed ~¢ smd work and to mae m~d file this applicaaon; fl~at al smtemen~ contained in tiffs applicaSon are ~¢ to ~¢ best of his ~owledge ~d belief; m~d fl~at fl~e work will be performed m dm intoner set forfl~ in ~e applica~on filed hemwi~. Sworn to before me ~is; Nota'y Public: ~~ }..~.J..: .................... ..................... FORM - 06/07 VICKI TOTH (Signature of Applicant) No. OiTO6-~§l~696- ....... O.ualflied in Suffolk County ~mrmssion Ex~re~ July 28, 20/1 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER .- "TRE'-" ~ ¢'~ ~ c, j ~/t.3..) VILLAGE DIST, SUB. ~m~n~K,' ~ ~o , 1,~1 ~ ~ ~'~ ~3 ~'~ S W ~PE Of BUILDING S. ~/O S~S. VL FA~ COMM. CB. MISC, Mkt. Value ~ND IMP. TOTAL DATE REMARKS FA~ Acre Value Per Value , / Till~ ~0 V IJt&/¢g rillable 3 Swomplond FRONTAGE ON WATER ~rushland FRONTAGE ON ROAD BULKH~D ~ot~l D~K M. Bldg. ;sion Extension L Garage Total COLOR TRIM Fo~Kdation ~ment Ext. Walls Fire Place Type Roof ~reation Room Dormer Driveway Bath Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floor Dinette LR. DR. BR. FIN. B. COLOR TRIM Extension tion ~ment Ext. walls :ire Place ~ Roof eation Room Floors rior Finish eat ns 1st Floor ams 2nd Floor COLOR TRI,M Extension ~rch tion ;merit Ext. Walls :ire Place ~e Roof :reation P~oom Both Floors nterior Finish 4eat 1st Floor Rooms 2nd Floor .~_ )inette DR. FIN. B. Southold Town Building Department 54375 Main Road Southold, New York 11971 (631) 765-1802 Parcel ID: 115.-13-14 Permit #: 34168 Permit Date: 9/18/2008 Expiration Date: 3/18/2010 BUILDING PERMIT RENEWAL LETTER Dated: 2/17/2011 Applicant: DAVID & MARIA SMITH Location: 1200 THERESA DR MATTITUCK, N.Y. 11952 Work Description: RESIDENTIAL ALTERATION INTERIOR ALTERATIONS TO A SINGLE FAMILY DWELLING AS APPLIED FOR. A FEE OF $200.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Address: MARIA & DAVID SMITH 1200 THERESA DR1VE MATTITUCK, N.Y. 11952 The permit listed above has expired. Please contact our office as soon as possible to begin the renewal process. All work on the project must stop on the expiration date. No work is permitted or authorized beyond the expiration date. THANK YOU, SOUTHOLD TOWN BUILDING DEPT. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD March 18, 2011 Maria Smith 1200 Theresa Drive Mattituck, NY 11952 TWO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: __ Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. ~ t~/[~. ,~'f_cl~ .~ ~ Afeeof$2§.00. 13v"q'~"~ ~-/'~ ~ Final Health Department Approval. ~ Plumbers Solder Certificate. (AJi permits involving plumbing after 4/1184) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 34168-Z interior alterations