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HomeMy WebLinkAbout28813-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28980 Date: 10/09/02 THIS CERTIFIES that the building ACCESSORY Location of Property: 2435 LAUREL WAY MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 121 Block 4 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 8, 2002 pursuant to which Building Permit No. 28813-Z dated OCTOBER 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 "AS BUILT" REPAIRS TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to CAROLE RICH & DONALD E WILDER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1081623 09/27/02 PLUMBERS CERTIFICATION DATED N/A r hor' ed Si nature 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. 28813 Z Date OCTOBER 10, 2002 Permission is hereby granted to : CAROLE RICH PO BOX 720 MATTITUCK,NY 11952 for "AS BUILT" REPAIRS TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR at premises located at 2435 LAUREL WAY MATTITUCK County Tax Map No. 473889 Section 121 Block 0004 Lot No. 016 pursuant to application dated OCTOBER 8, 2002 and approved by the Building Inspector to expire on APRIL 10 , 2004 . Fee $ 150 . 00 Z (22, Signature ORIGINAL Rev. 5/8/02 rC o e(� .� K �. 7a.Tj 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 Depa>ltment with the following,: l 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 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$25.00,Additions to dwelling$25.00, Alterations to dwelling$25.00, Swimming pool $25.00,Accessory building$25.00, Additions to accessory building$25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. /Zw�O2 New Construction: Old or Pre-existing Building: ✓ (check one). Location of Property: 2 5� 3 1g- L/74ALo ts'Z ouifyi H 4 7- Ty G/L House No. Street Hamlet Owner or Owners of Property: C4,90 L td d&_4 G L,( 14 e90X) "y-C4 d- Gc)�C ✓)tj� Suffolk County Tax Map No 1000, Section /Z l.o o Block ¢ Lot 16,oOC) Subdivision Filed Map. Lot: Permit No. g�� �j Date of Permit. w \v O')— Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approvals Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ C, G a,�lo� Applicant Signature D r �����P�@P�PrPrPJ��PnPn�� o �� �rJ� � . P ��Pc �-PcnRME11:MJ Pr � � �PrJPrJ�P�Pr � 5 S5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 BUREAU OF ELECTRICITY ' S 40 FULTON STREET — NEW YORK, NY 10038 5 5 CERTIFIES THAT 5 5 Upon the application of upon premises owned by 5 5 5 5 DONALD WILDER DONALD WILDER LAUREL WAY 5 PO BOX 720 5 5 MATTITUCK, NY 11952 MATTITUCK, NY 11952 5 5 Located at 2435 LAUREL WAY MATTITUCK, NY 11952 5 5 Application Number: 1081623 Certificate Number: 1081623 C5 5 Section: 121 Block: 4 Lot: 16 Building Permit: BDC: NS11 C5 5 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 Detached Garage,Outside, 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 27th Day of September,2002. 5 Name QTY Rate Rating Circuit LTe Amount5 5 5 5 Invoice Total $75.0 5 �5] No visual defects: an elctrical survey has been made of the exposed electrical equpment in the premises indicated. No obvious unsatisfactory 5 5 condition was found. 5 5 5 5 5 5 5 5 5 5 5 seal 5 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 D rJ�rJ�rSr�rrrJ��rrJ�r�r�rJ�rJ��nr�rJ�r�r�rJ�r�rJ�rJ��nrJ�rJ��PrJ�rJ�r�rJ�r�rnrJ��rrPr�rJ�cJ�rJ�rJ�r�rJ�rJ�rJrJ��PrJ�rJ�cPrJ�r rrJ�rJ�rPrJ�rJ�rPrJ�r�rJ�rJ��Pr��P 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 X' 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 '� Survey, www. northfork.net/Southold/ PERMIT NO.c�288 I /so Check Septic Form N.Y.S.D.E.C. Examined 20 ,t Trustees Contact: Approved io /e 20 Z— Mail to: Disapproved a/c Phone: Expiration 20 Building Inspector APPLICATION FOR BUILDING PERMIT 3 Date SST Z 3 20 0 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 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. (Signature of applicant or name,if a corporation) J< 7?—b -7'Uc/c it1 Y ll QS„ Z. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder tx vri Name of owner of premises C 114o1 � Ao C1q 4 Qp,yIgi,,' er' W/cJ0&-/'` (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: 44-36— L 4-UAt----L A-v .4147-77 7-0C/<= �j House Number Street Hamlet County Tax Map No. 1000 Section / 0/ Block If- Lot /4�9 • oo O Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy E-414,e"&5- b. Intended use and occupancy eV-1R4-6 e3 3. Nature of work(check which applicable): New Building Addition Alteration Repair_Removal Demolition Other Work 4. Estimated Cost_ 600 0o Fee (Description) (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. PER dTrM 0 C- 7. Dimensions of existing structures, if any: Front 2? < ` Rear epth Height F '—7 " Number of Stories i 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 i"ems Lj(-n-42 9. Size of lot: Front / /7_ /(� Rear /� , o Depth 3(vb 8 10. Date of Purchase / aj Name of Former Owner a*~Z2DqfzXJ 46 c AoC& g'lc—,H 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 ✓Will excess fill be removed from premises? YES NO ri cor4joc fa AKK P.O. Sox 72.0 14. Names of Owner of premises DQL&C( �, Address/'�/�r 77 Tuc.K ,v y Phone No. ',QS- - 4-(.16 Name of Architect Address Phone No Name of Contractor Address Phone No. 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 feet or below, must provide topographical data on survey. 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, (S)He is the ® Lk-')P (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 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 this day of �� 20 0- ' 11 4 V, �"-- :� No y Public Signature of Applicant NS NotaJOYCE blic,St to ofNewYork No.4952246,Suffolk County Term Expires June 12, ACU 03 SURVEY OF PROPERTY AT MATTITUCK T 0 WN OF SO UTHOLD SUFFOLK COUNTY , N. Y. 1000- 121 -04- 16 & 17 SCALE: 1 " =30' 1�D A • 4AAL 8, 000r O� \ :9,00. r �� Fe N jQOO 4? b 1bb \j�j \ ��. _ la Op b co eb1\\\\ �Iy •� oRIJE -- 36 (q 34 30 le Itt I/ - 39 20 30 26 400 \ 14 5 134' B 0 a I FR 40- le rLOG CSTY6TTAW loa' P pM ;; 9S Pq T10 b 21,0' 1`l >B' U14 /v '700 , 0 V / p z � ORv Z jb+ I0'~ TIE LINE TIE LINE SHORE LINE W 97.77' 19.39' o& S 86'28'00' W LAUREL LAKE 1000-121-04-16 AREA-20,518 S. F. to tie line 1000-121-04-17 AREA=20,301 S.F. to tie line ,ApT6il 0�' E'�A.AST AR��ERENCED T]'O TW S T APMC AMA�°+9A404V.D P.�EOF NEIb yo ,*=MONUMENT S�NO N t. METZG 9� ANY CTERATIIJN OR ADDITION TO THIS OF SECTION SURVEY IS A VIOLATION f�". N. Y.S. LIC, ND, 4961P 7209 OF THE NEW, YORK STATE EDUCATION LAW. _ EXCEPT AS PER SECTYON 7209-SUBDIVISION P, ALL CERTIFICATIONS C S EYORS, P,C. HEREON ARE VALID F17P THIS MAP AND COPIES THEREOF ONLY IF ' 020 0� 020 FAX (6.31) 765-1797 S41B MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR P, Lm 0 1.l n'Ev CTf:NGTIIPF 4PPF4RC HFRFnN. 9 1230 AVELERSTREETFoo - 35i] �, n A111 1 ,11, N Z� 7 AS -6 � �-.tiS7--NIS MKld e&-7W O!5'riQ/L /z'-8it ,\ o \ V \ ST&74Y,5 SV7 EL UNDERNITERS CERTIFICATE REQUIRED 4-wsrmy�v APPROVED AS NOTED Z X is T1116eK (6c-ru A MR 300 �(z NO NOTIFY BUILDING� EPARTM NT AT C 8 X8L X l h GC�Mct T (GOC 765-1802 S AM TO 4 PM F THR w/3«s, W.,774 Z "x 8 P 1.FOF UNLLOWID T ON -INSPETWO RE IRED CROSS BLfins FOR POURED CONCRETE 2 ROUGH - FRAMING & PLU BIND ¢ "X � " P©STS 2 f =/ " 4, FINAL - CONSTRUCT MUST D BE COMPLETE FOR C.0. ALL CONSTRUCTION SHAL MEET (Z) R0019-9f 0 Cf1P ?"10 THE REQUIREMENTS OF T1 E N.Y. ACePC/�CeO CX/ST//V C--> STATE CONSTRUCTION A E IERGY CODES. NOT RESPONSIBLEFOR ,eo©/= Oe'cK ( -7Xz '/ " A 3/4- DESIGN OR CONSTRUCTION E 61iiRi 7olt16og- I Geoo le PrNg /N CBoss H/9.7cWe-,0 ICe_09 ® Cv i TN 's PL YGvo oD o3N o 2X(,5 o%iT (e U�JAJ/OG e19-57-- WeS-r). Z f"C <925 p.'qo" OCCUPANCY OR 5E/ /1-5 ngs-to4loe ,e cop co%ent,vG USE IS UNLAWFUL AO /4,5 WITHOUT CERTIFICATE Be� S f� GoaD cow - OF OCCUPANCT I I 0171aAJ 6A� OF EW //4? Ol- EX1,5 TING GAAGE _24-36-LA-UR`L-WA Y, AIR 7-7-/ TvC K,N Y �Fo NO 05251° �� SUI F00< C®. T/4X K/4PA,10. /000) SECT. /Z/. 00, A540C,C"4, L©T" /6. 000 o Gur�/JtjIL A FFss�o�', ScigLF': %8" =/ =o" 11A1s/D0- 40cT'rf/44504) 5� /