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HomeMy WebLinkAbout28452-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28720 Date: 08/21/02 THIS CERTIFIES that the building ELECTRICAL Location of Property: 2040 CENTRAL DR MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 1 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 5, 2002 pursuant to which Building Permit No. 28452-Z dated JUNE 10, 2002 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 NEW ELECTRICAL SERVICE TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BARRY D EARTH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1059666 06/17/02 PLUMBERS CERTIFICATION DATED N/A Authorized Sii0ature Rev. 1/81 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. 28452 Z Date JUNE 10, 2002 Permission is hereby granted to : BARRY D BARTH 2040 CENTRALL AVENUE MATTITUCK,NY 11952 for . ELECTRICAL UPGRADE TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2040 CENTRAL DR MATTITUCK County Tax Map No. 473889 Section 106 Block 0001 Lot No. 026 pursuant to application dated JUNE 5, 2002 and approved by the Building Inspector to expire on DECEMBER 10, 2003 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 ' fii. ,�'►� 11952 A ,, ;;_; Form No. C, , IOtiVN OF SOUTHOLD BUILDING DEPARTMENT TO«mr BALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAkNCY "fir n j This application must be filled in by typewriter or hilt 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 iu systeni coutaius less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certific 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 us 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupan is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00, Alterations to dwelling$25.0( Swimming pool$25.00,Accessory building$25.00, Additions to accessory building$25.00,Businesses $50.0 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential $15.00, Commercial$15.00 Date. 6 Z z/. 20o Z New Construction: Old or Pre-existing Building: I✓ (check one) Location of Property: y 4l o CENT>z A L17 j2/ v G IV A T i r i U C k // t/ House No. Street Hamlet Owner or Owners of Property: 13 tQ n re.✓ TIV Suffolk County Tax Map No 1000, Section G Block 0 / Lot Z 6 Subdivision Filed Map. Lot: Permit No. Date of.Permit. Applicant: 0 n rz 2-v Health Dept. Approval: Underwriters Approval: 1 S j (,6 6 Plairning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ S a� Cie .baa y6 Applica Signature C o -a� 2t- ) tee cPrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rnrJ�rJ�rJ�rJ�rJ�rJ�rJ�rP�PrJ�rJ�r�rJrJrJrJ@P�Pr:1 1! ,�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�jM RPL QLrL�rJ�cP�JrJ�rJ�rJ�rJ�rJ�r�rJ�rJ�rJ� O 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 C5 BUREAU OF ELECTRICITY e5 40 FULTON STREET -- NEW YORK, NY 10038 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 BARRY BARTH BARRY BARTH2040 5 5 MATTITLICK CENTRAL DRIVE Y 111 T 9.2 MAT UCCENTRAL DRIVE Y 111952 5 S 5 5 Located at 2040 CENTRAL DRIVE MATTITLICK, NY 11952 5 Application Number: 1059666 Certificate Number: 1059666 5 �5 Section: Block: Lot: Building Permit: BDC: NS11 5 �c Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring,described below, located in/on the premises at: 5 5 Basement,Outside, 5 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 17th Day of June,2002. 5 5 Name OTY Rate RatinH Circuit Type 5 Service 5 5 1 Phase 3W Service Rating 200 Amperes 5 5 Service Disconnect: 1 200 cb 5 5 Meters: 1 5 5 5 5 5 5 5 5 5 5 5 5 5 sea, 5 5 1 of 1 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 D r1,rrJ�rJr�rJr�rJrJrJr,rJjIrJ�r �rJ�rJ�rJrJrJrnrJrJrJ�rJ�rJrJ�r1r�rJr�rUr�rJ�lrJ@JrJrPr�r 1C Z frJrJ�rJ�rJ�rJflJ�rJrJr- XrJ-� 2003rJ-rJ�fr3-d- -I-- R3 0 o ApplicanU Date Owners Name: "' Reviewed: Architect/ Date Cngineer. Submitted: 5 SCTNI M: District: 1 .000 Secy on: OC- 13 lock ProjectL1 Subdivision L.ocalion / Single S- separate Required cerUfiFation: -le-11 Nol ��Tr R q _- -_.--_. tcy. /Doing DistrctR O, /3 1ropa�cJC:7 C(mil coverage Req. I Req. /1 Req �--s� (front Yard_S0 proposed:�, O�j [Side Yard Proposedcj � l [Rear Yard'"�D + p �. - 1 r0�0>CP���y}�- Project Description: V- AGENCN' E� RMITS Permit RFQUIRED FOR RI•;VIEW N.A. NO YES Number Suffolk County Health,Dept. New York State D. E. C. / Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Place Elevation??? Flood Zone: TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET ,-,2 VILLAGE DISTRICT SUB. LOT 3 FORMER OWNER N E ACREAGE 4 1. 31 Con ,- S WTYPE OF BUILDING l ,ES. J u SEAS. VL. FARM COMM. IND. CB. MISC. 'LAND IMP. TOTAL DATE REMARKS .Zo U J`n n a 4z Q L 3 6 r 31 9 L 24 300 iylPskour<< vrs j � o1D0 4/70b 7700, J J6 7 jF'P T L AGE BUILDING CONDITION 1 3 Doi- (1►'i5QI1�'7U ,/ NEW NORMAL BELOW ABOVE 0I 0 � 3� � = 2 7,�6 Farm Acre Value Per Acre Value Fillable 1 wRON 'T - Fillable 2 _ Fillable, 3 vVoodland Swampland Brushland House Plot Total ■■■■■■■■■■ALAI■■N■■■■ ■i■■■■lii■■tri■■N■■ r. ■■■■■til!■■■■■■■■�'�ir�YN a ■■■■■■■■iia■■�'1i'�■■■■■ . .. . :. th Extension J� Y -;-100 Basement Floors Ext. Walls Interior Finish Extension :xtension Z3 xtension Heat Porch Attic Porch Rooms Ist Floor r Patio Rooms 2nd Floor . Ge . .. Driveway TOWN OF SOUTHOLD 52002 i BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT -- ----___.! Do you have or need the following,before applying? WN TOHALL _._. _. . Board of Health SOUTHOLD,NY 11971 G T t I O L D 3 sets of Building Plans 1'' c ". i TEL: (631) 765-1802 - Planning Board approval FAX: (631) 765-9502 Survey PERMIT NO. Check Septic Form N.Y.S.D.E.C. Examined 4 6 8 ,20 C OContact:Trustees Approved b4(t)_,20 Mail to: Disapproved a/c Phone: Expiration a- `r ,202_ Building ` -..`= rn APPLICATION FOR BUILDING PERMIT Date S- u Z —, 200)- INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 BEREBY 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 Yor Regulations, for the construction of buildings,ak, and other applicable Laws, Ordinances or dditions,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. (Signatofe of applicant or name,if a corporation) OCCUPANCY OR "ER"'TERScorn zd c0,v-rR2� >,Z `hPc-tf; REQUIRED (M��g addresslvr of applicant) State whethe U E I U�NLAY tgent, architect, engineer, general contractor, electrician, plutnbr or builder OF OCCUPANCY Name of owner of premises G4 rz.,i ) i3�,ZT�a pA 8 (As on the tax roll or%$Lima If applicant is a corporation, signature of duly authorized officer A lea-1802 S AM TO 4 PM POR T js (Name and title of corporate officer) FOLLOWIN ew ECI'I N& 1 FOUNDATION • Tw0 REOUIREo Builders License No. FORPOUREDCONCRETE Plumbers License No. P. ROUGH - FRAMING i pLUMeINa I INSULATION Electricians License No. / 6 S' rS c + + un. -Pj fA Wn VON MUST Other Trade's License No. ALL CONSTRUCTION SHALL MEET 1. Location of land on which proposed work will be done: THE RECUIREIIENTS OP TNg N.x 12 0 1Y a C r /tn 6 v r AT T i T u C i-STATIC STRUCTION • ENERGY House Number Street Coolps- 01 RROP"WaLl FORp County Tax Map No. 1000 Section-[212o Block (OG _ O 1 Lot 2,G,j Subdivision c/o p n;n k , �> t=t+„k s Filed Map No. /6 7 L Lot (Name) 2. State existing use and occupancy of premises and intended use,tgnd occupancy of proposed construction: a. Existing use and occupancy g c s, b e,vc r= b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Workye S e l r ek R L, 2 00 A q,►o (Description) SPA„r c e 4. Estimated Cost Fee !S - a'"-(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 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, ordinance or regulation?YES NO ' 13. Will lot be re-graded?YES NO x Will excess fill be removed from premises?YES NO_ 14. Names of Owner of premises&a tm , D. r�srrtl Address 20 yo CeJ d Dry Phone No. Z-r8 /G Z 3 Name of Architect Address Phone No Name of Contractor 5r7 � ���o�. Address�o G 8r' Phone No. 6 31 -3 zs- Z 3 3 s 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 of a 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 t„Q elgw,must,provide topographical data on survey. s STATE OF NEW YORK) N` a SS: , COUNTY OF CU4TO IV,) a being duly sworn,deposes and says that(s)he is the applicant (Name of indlhftls g contract named, (S)He is the rA TV0 P'A,�d p iAgAit,Corporate Officer,etc.) 'HT Poll M4 A OT MA ! St19t"a, of said owner or owner$;.4 2MiWtI perform or have performed the said work and to make and file this application; that all stat c�Aa pir3Vd1`urtW11 lictatit 4e true to the best of his knowledge and belief; and that the work will be performed in the manned"ski% i ''atictiQn filed therewith. OVIGMUJ9 j QjAMAki . . +: Sworn to before me this JC 3 000 t? .A . • ��9� Y Twl: iT; trl00 9TAT9 SigCwture of Applicant &ROPMF No.01RE5070894 d to Suffok County C n EVhs Ds=nt r 30,a �— SURVEY OF LOT 3 MAP OF CAPTAIN KID ESTATES BLOCK No. 1 FILE No. 1672 FILED JANUARY 19, 1949 , SITUATED AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK � .� S.C. TAX No. 1000- 106-01 -26 SCALE 1 "=30' y� ` DECEMBER 26, 2001 WOOD DECK G.FL. - .. nAOE R TOP OF BLUFF T.W. - TOP [+R W 9.W. - 90TMM 0 1 100 /96 10 ° \ / ,92 �\ 11 ,90 do I \ gar �\ \ IN xw 90 i / // //// / xl /.� • \ \x \9? // / / . , •. \ • � x91./ ^�� l%1 /// % � �4.�, � ::` '• �`.+�-1� ray \\ 9< 9 0- 1 � � I I I .9,}..! .��h�4 G4�' • �, � � its \\ dt � O � • Trn \ •• xmi 90 90.3x1 \ 1 xAw / 86 \\ x e � PoLE cp UNATHORM ALTERATION OR ADDITION TO THIS SURM IS A VIOLATION OF � 1 \� x ,• SECTION7Z0OF THE NEW YORK STATE + 1 EDUCATIONCOPIES OF THIS SLIMY NAP NOT KA M5 \.�7.2C7T p 90" .. �, THE LAND SLWNEYdtl WED SEAL OR !• ENBDSSED SEAL BiIAL1 NOT K CONSIDERED FOUL .�� 7D SE A YAUO TRUE COPY, 140H• \ P. / ' R CERIIFCMXMS MOICATED HUMON SiMLL RUN `, •. • , A '( TO THE IS FWARD AV PQ190pp1►N1�IN IqS To WNDM THE (m (7 'r]1 lY1 TITLEGtfMpA�lY00MIENiAOENCY No 1\`11 1 1R" C LE04Da10 MSIRl1IlON LaerED . AND •1� " ; . TO THE AselotlEEs OF THE I D INSTI- .' .. : .' MKIN. CERrwTCAfloM+s ARE TANGFERAKL ..� THE EXISTENCE OF RMTS OF WAY 1965 AND/Olt US MEM OF RECM, IF ANY. NO SHOWN ARE NOT GUARANTUD. ...TOP OF BLUFF.1. a ' I I q I P j I I 040 It if III 1 .1 lid j ^t4 GD � 1 \ \ II \ \ 1 Nae \ 11 PREPARED IN R TME SURVEYS THE MIINAUM e6- \ \ I STANDARDS FOR TI1LE SURVEYS AS HED 9Y THE'LAA AND APPROVED ANO \\ \ FOR SUCH ll� 9Y THE NEW YORK STATE LAND \ \ ME ASSOCIATION. i AL 7r 4- > 9 3 y0. ni N.Y.S. Lia No. 49688 In LINATHOMED ALTERATION OR ADDITION 70 THS �ANEY ' A VIOLATION OF Joseph An Ingegno SEC .� T SOF THE NEW YORK STATE � Landpurveyor COPIES OF THIS su MW NaT NO7' K TK LAND *M SM O D MOM OR A VALID TRUE COPY. Fµ CERTIFICATIONS INDICATED HEREON SKAULL RUNNY Titla Surveys — Subdh*ione — Site Plana — NOrutnxtion Layout ONLY TO PUMN IN.s�F HE riNE TITLE 660W. AL AGENCY Me PNONE (631)727-2090 Fax (831)727-1727 U I�� To �LHERION. AND �N�p TUi1pN 110 8� NOT � OFFICES LOCATED AT AWUNG ADORESS 1380 ROAN OKE AVENUE P.O. Box 1931 THE EXISTENCE OF AMU OF WAY RNE*WAD. Now York 11901 RivefiwA, Now York 11901-0985 AND/Olt EAtYMENTS OF RECORD, IF ANY. NOT SHAWN ARE NOT IOUARAPITEED.