HomeMy WebLinkAbout38837-Z Town of Southold Annex 5/8/2014
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36897 Date: 5/8/2014
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1455 Factory Ave, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 122.-2-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/21/2014 pursuant to which Building Permit No. 38837 dated 5/1/2014
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" foundation and roof repair to an existing accessory garage as applied for.
The certificate is issued to Williams, Shawn&Williams, Dawn
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38837 3/13/14
PLUMBERS CERTIFICATION DATED
Aut e ignat e
4 Town of Southold Annex 5/8/2014
5'eP.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36898 Date: 5/8/2014
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1455 Factory Ave, Mattituck,
SCTM#: 473889 Sec/Block/Lot: 122.-2-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/21/2014 pursuant to which Building Permit No. 38837 dated 5/1/2014
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 one family dwelling as applied for.
The certificate is issued to Williams, Shawn&Williams, Dawn
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38837 3/13/14
PLUMBERS CERTIFICATION DATED
1
Au o ed ignatu
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
' SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 38837 Date: 5/1/2014
Permission is hereby granted to:
Williams, Shawn & Williams, Dawn
405 South Dr
Mattituck, NY 11952
To: As built alterations to an existing single family dwelling and as built alterations
(foundation) to an existing accessory building as applied for.
At premises located at:
1455 Factory Ave, Mattituck
SCTM #473889
Sec/Block/Lot# 122.-2-16
Pursuant to application dated 4/21/2014 and approved by the Building Inspector.
To expire on 10/31/2015.
Fees:
AS BUILT-ACCESSORY $200.00
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00
1: $600.00
Building Inspector
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:
I. 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 I%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 Planning 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: V (check one)
Location of Property: PA5� �Gc �`� � - -�s�c,�C_
P rtY�
IIouse No. Street Hamlet
Owner or Owners of Property: t
Suffolk County Tax Map No 1000, Section Block Lot l
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ , _
-�o Y
Applicant Signature
r
i
�o��oF so�Tyo6
TOWN OF SOUTHOLD BUILDING Di T. 3
r3�
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ } FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) Y ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
J
215 YS r�t ilk'� �G�—co — c�
DATE �f INSPECTORS � �
JAMES J. DEERKOSKI P.E.
260Deer Drive
Mattituck,NY 11952 /
(631) 774 7355
Date: March 17, 2014
To: Town of Southold Building Dept
Re: Williams
1455 Factory Ave.
Mattituck,NY 11952
To Whom It May Concern:
This letter certifies that an inspection was performed on the above mentioned dwellings
Floor system and a recommendation was made to reduce the floor beam span length by
installing a LVL girder and piers/lolly columns mid span. The work was done as per
State and loc odes and is safe to use. The two out buildings were also looked at and
these two buil 'n are structurally so d and also safe to use. Any questions feel free to
call.
Si erely,
•r
J es J eerkoski P.E.
FIELDINSPE N RESORT
DATE COM EMS
• FOUr1DATzoN(1ST)
FOUNDATION(ZND) 41.1k.4
z
(.n
ROUGH FRAMT1 Q& y
PLUMBING
l J
INSULATION PER N.Y. H
STATE ENERGY CODE
MAL
ADDTftbi4AL COMMENTS
14 QS,,KQ C.
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health ,
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined ,20 Storm-Water Assessment Form
Contact:
Approved ,20 Mail to:
Disapproved a/c ,
Phone:
Expiration ,20
\\J B:uilding Inspector
2 1 2014
PPLICATION FOR BUILDING PERMIT
I APR
Date p� , 20
INSTRUCTIONS
-a:-a. a licat-` iJ—l–
L pp on 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 nQ zgning.amendments or Esther regttlation5 affecting the
property have been enacted in;the4riterim,the Building Inspector,may authorize, in writing,the extension aftheaperniitfor an
addition six months. Thereafter,anew permit shall be requ
p iredl,. , • -. ;:
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 Sou old,Suffolk.County,Ncw,York, and other applicable.Laws,Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein deseribed..The
applicauthorized nt gnses to ectors on comply rem premisesandin buildincable wfoordinances,building code,housing,code,and regulations,and to admit
P P g r necessary-inspections.
(Signature of applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
Name of owner 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 License No.
Electricians°License No. � } _
Other Trade's License No.
1. Location of land on which proposed work will be done:
l '-i S o..e-- � 113Z-
HouseNumber Street Hamlet
County Tax Map No. 1000 Section - Block � -1 Lot
Subdivision Filed Map No. Lot
2. :State existing use and occupancy,of pre es and intended use and occupancy of proposed construction: m,
a. Existing use and occupancy
b. Intended use and occupancr-,ec - Nn gzAQ a'
0
c0f, ce,-� w,, cyt—
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 Number of dwelling units on each floor
If garage, number of cars ' 1
6. If business, commercial or mixed occupancy, 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 Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
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,#oxduiance or regulation?YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO
14. Names of;Owner of premises x :f ;° Address Phone No.
Name of Architect _ t d . p Address,,, Phone No
Name of Contractor Address ` ' Phone No.
sus
15 a. Is this property within-100 feet of°a tidal wetland-or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWNTRUSTEES'&D E.C. PERMITS MAY BE REQUIRED.
b. Is this property within J00'feet ofa 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.
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 )
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named, CONNIE D.EUNCH
Notary Public,State of New York
No.01SU6185050
(S)He is the _____0dalfled in Suffolk Ceunty
(Contractor,Agent,Corporate Officer,etc.) Commission Expires April 14,2_
ILP
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 true to the best of his knowledge and belief, and that the work willbe
performed in the manner set forth in the application filed therewith.
Sworn to before me thi
1 —41* day of 20
Notary Public Signature of Applicant
pF SO�jyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179 G • roger.riche rt(D-town.southold.ny.us
Southold,NY 11971-0959
c4UNTY,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Shawn Williams
Address: 1455 Factory Ave City: Mattituck St: NY Zip: 11952
Building Permit#: Section: 122 Block: 2 Lot: 16
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic Garage X
INVENTORY
Service 1 ph 200a Heat gas Duplec Recpt 31 Ceiling Fixtures 9 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 7 Wall Fixtures 4 Smoke Detectors 4
Main Panel 200a A/C Condenser Single Recpt Recessed Fixtures 14 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliancesdw Dryer Recpt 1-20 Emergency Fixture Time Clocks
11
Disconnect 200a Switches 22 Twist Lock Exit Fixtures TVSS ri
Other Equipment: 2-exhaust fans
Notes:
Inspector Signature: Date: March 13 2014
zr
81-Cert Electrical Compliance Form.xls
so�ryQ�
0
Town Ball Annex J Telephone(631)765-1802
54375 Main Roadcn (631)765- 50`
P.O.Box 1179 • roger.richert(aown.sout�iod.ny.us
Southold,NY 11971-0959
�UIVT't,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required information) /'� �
*Name:
-S
*Address:
*Cross Street:
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: ZZ Block: 2.- Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Lt 9 ( �" -��' - �r
(Please Circle All That Apply)
*Is job ready for inspection: YES / NO Rough In Final
*Do you need a Temp Certificate: YES / NO
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form
,iA6 ,.
APPROVED AS NOTED
DATE:5 1I ►q B.P.# ?SS��
FEE: � BY: Pe-
M C H
NOTTY BUILDING DEPARTMENT AT Design Services
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1.-FQUNDATION - TWO REQUIRED
FUS, POURED CONCRETE WWW.mchdesionservices.com
2,ROUGH - FRAMING & PLUMBING
3. INSULATION phone:
4. FINAL - CONSTRUCTION MUST - (631)298-2250
BE COMPLETE FOR C.O. '' e-mail:
ALL CONSTRUCTION SHALL MEET THE michael@mchdesignservices.com
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
" .. �
��' '�`--' COtVIFLY WITH ALL CODES OF
E:10 ED
NEW YORK STATE& TOWN CODES
AS REQUIRED F
" S6bTOOtrOffl MA
` S OARD
33'-9"
TRUSTEES
FRONT ELEVATION-
SCALE:
1/4" = 1'-011
OCCUPANCY OR
FOUNDPTION REPLACED I 1 COURSE BLOCK WALL ADDED TO EX. FOUNDATION
USE IS UNLAWFUL
--------------------------; WITHOUT CERTIFICATE
' IONOF OCCUPANCY
PLUMBER CERT_ZFJ J11-
ON LEAD-cof�f E11ra
I
CERTIFrF6A:i&
POWPANOY
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. NOTED ON PLAN °
CROSS SECTION-
SCALE:
1/4" = 1'4"
REAR ELEVATION DRAWN BY: MH
SCALE: 1/4" = 1'-0" 4/7/2014
Y°� SCALE: 1/4" = 1'-0"
A iDEE Ar
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SHEET NO:
sF(��OIFE7'2. �.
M C H
Design Services
www.mchdesianservices.com
phone:
(631)298-2250
e-mail:
michael@mchdesignservices.com
SITTING ROOM COVERED
PORCH W
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II
II
II ENTRY
II
BEDROOM I I w
00
STEEL LALLY COLUMN
24"X24"X12"CONC.FTG.
— — — — — — — — — — — — — — — — Ej 4X4 POST -----
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— — — — — — — — — — — — — — — — - - - - __'8NEW(3)7-1/4MLGiIRDER,— - �- - - -
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HH 51-511 61-8'/2111 61-6'/211 W
M M
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EXISTING 2ND. FLOOR PLAN: 11F�� ��1111
SCALE: 1/4 = V-011
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BEDROOM KITCHEN EXISTING CRAWL SPACE
EX.RR REPLACED
w/2X8 @16"OC
BATH
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ENCLOSED PORCH LNDRY.
ROOM
EXISTING FOUNDATION PLAN-
EXISTING
IST. FLOOR PLAN SCALE: 1/4" = V-0"
SCALE: 1/4" = V-0"
DRAWN BY: MH
4/7/2014
NEW Yo SCALE: 1/4" = V-0"
LjSHEET NO:
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