HomeMy WebLinkAbout28698-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28974
Date: 10/09/02
THIS ~TIFIES that the building ADDITION
Location of Property: 1325 LUPTON PT RD MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 115 Block 11 Lot 9
subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 27, 2002 pursuant to which
Building Permit No. 28698-Z dated AUGUST 27, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JOHN J GUTLEBER & ORS
( OWNER )
of the aforesaid building.
SUFFOLK COUIFrY DEP~T~ENT OF H]~LTH APPROVAL N/A
ELR~-r~ICAL CERTIFICATE NO. 1077011
PLUMBERS CERTIFICATION D~I'F~3 N/A
09/13/02
+/~z~S~na , . re
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUIT~ING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28698 Z Date AUGUST 27, 2002
Permission is hereby granted to:
JOHN J & ORS GUTLEBER
34 HARBOR HILL DRIVE
LLOYD HARBOR,NY 11743
for :
CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR. THIS BUILDING
PERMIT REPLACES BUILDING PERMIT #18618Z
at premises located at 1325 LUPTON PT RD MATTITUCK
County Tax Map No. 473889 Section 115 Block 0011 Lot No. 009
pursuant to application dated AUGUST 27, 2002 and approved by the
Building Inspector to expire on FEBRUARY 27, 2004.
Fee $ 150.00 /~~~.~~
v Authorized Signature
Rev. 5/8/02
ORIGINAL
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)
N~- 18 618 Z
Permission is hereby granted to~
...z~.~..~.~~..~..s~......
,o ...~~~....~...~...~...~~:..._ ~~ .~. ~....~
~.~~~:~....~.. ..... ~~....~~~ ...............
£~d~,~o~o~ ...... ../.. ...... ~~..~..~....~.;.~/.,. .....................................
................................................. ....................................................
County Tox Mop No. 1000 Section ........ d../.,.~....'~..... Block ........ ../'../... ...... Lot No .....~.. ................
pursuant to application dated ........................................................ , 19 ........ , and approved by the
Rev. 6~30/80
'~WN q~ 5Q~.J~?rOLD
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:
Ao
Co
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 Planning Board Approval of completed site plan requirements.
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.
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
New Construction:
Location of Property: I 3,~
House No.
Owner or Owners of Property: ~O(~J G cc~-L~'g ~/C
Suffolk County Tax Map No 1000, Section { ( ~'-
Subdivision
Old or Pre-existing ~4}lding:
Street
Date of Permit.
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Date.
(check one)
o
Hamlet
Block / ( Lot COO ~
Filed Map. Lot:
Applicant:
Underwriters Approval:
Final Certificate: /_ ~~~.(ne) ~
Appliant S~gnature
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
JOHN GUTLEBER JOHN GUTLEBER
340 HARBOR HILL DR 1325 LUPTONS POINT RD
LLOYD HARBOR NY 11743 MATTITUCK, NY 11952
Located at 1325 LUPTONS POINT RD MATTITUCK, NY 11952
Application Number: 1077011 Certificate Number: 1077011
Section: Block: Lot: Building Permit:28698Z & 286 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:
Outside, Porch/Deck,
was inspected in accordance with the National £1ectdcal Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the 13th Day of September, 2002.
Name QTY Rathe Rating Circuit Type Amoun~t
Invoice Total $75.00
This is a statement of fees due for services rendered. This is not a certificate of compliance for any portion of the premises wiring system.
seal
This certificate may not be altered in any way and is validated onl by ~t[e presence of a raised seal at the location indicated.
RES. ~/.~_~ SEAS.
LAND
/P~
3~
VL
NEW
Farm
IMP. TOTAL
¢~o~I ~ ~ v
5ooo ~ ~o ~
O~: SOUTHOLD ! ~' ~ D CARD ::'~
~1 ~1:1:1 /3~2~ j DISTRICT "-S'.JB. LOT '
N
S
DATE ReMARKS.~/,~,/~,..,,
~1 I
NORMAL
BUILDING CONDITIO~
BELOW
Acre Value Per Acre
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House PI0t
Tara I
ABOVE
Value
Ga rage
? u/F: /7/
Foundation
Ext. Walls
Fire Place
Porch
Porch
Bath
Floors
Interior Finish
Hea~
Attic
Rooms 1st Floor
Rooms 2nd Floor
FRANK A. KUJAWSKI, JR., President
ALBERT J. KRUPSKI, JR., Vice-President
JOHN M. BREDEMEYER, III
JOHN L. BEDNOSKI, JR.
HENRY P. SMITH
TELEPHONE
(516) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
October 23,
1989
John Gutleber
1325 Lupton's Point Road
Mattituck, NY 11952
Re: Waiver for construction of attached deck to existing single
family dwelling located on Deep Hole Creek, 1325 Lupton's Point
Road, Mattituck, NY.
Dear Mr, Gutleber:
The following action was taken by the Board of Town Trustees
during their regular meeting held on October 19, 1989 as follows:
WHEREAS the Town Trustees have conducted an on site inspection of the
subject property,
RESOLVED that the Town Trustees approve the request made by John J.
Gutleber for a waiver to construct an attached deck to existing
single family dwelling, located on Deep Hole Creek, 1325 Lupton's
Point Road, Mattituck, NY.
Please return to the Building Department for a determination on
the need for any other permits which may be required for this project.
FAK:jb
cc: Bldg. Dept.
Board of Appeals
file
CAC
Frank A. Kujawski, Jr~Y~
President
Board of Town Trustees
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
PLEASE TAKE NOTICE that your application dated ~ a~-o~-- ~ .~. 19 ~ c~
for permit to ~..~,...~.-~....~...~ ............................ at
Location of Property ]'~ ..~.~~..?.r'...~¢.' .... ...~...~ ......
~t~us'e ~. .... ~ Street Hamlet
County Tax Map No. 1000 Section .... [[~. ..... Block ...... I) ....... Lot ...~..ct .........
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the following grounds. ~¥~ c~..~...~..~...~.~. 7! .~.~)
· ~...~,. '. %.. ~..-~ .~ '.:,,....~...~w....~.. ~.....~....~..~ ..x~~
.~.~._~L~. ~ ~ ~-"T;, ~ ~
-~_-....
Building Inspector
RV 1/80
INSPECTION
FRAMING [ ] FINAL
REMARKS:
INSPECTOR~/~~~~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.·
[ ] I~J~ION
[~!~ FINAL
[ ] FIREPLACE & CHIMNEY
DATE
FOU~;DATION (1st)
FOU!~DATIO~! (2nd)
ROUGH FRAME &
-PLUMBING
INSULATION FER N. Y.
STATE ENERGY
CODE
Fi::AL
ADDITIO~AL COMMENTS:
FORM NO. 1
ToWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
BOARD OF HEALTHt~...'"'/'/'''.
3 SETS Of PLANS
SURVEY,V.,
SEPTIC FORM .............
NOTIFY
$OUTHOLD, N.Y. 11971
, ' TEL.' 765-1802 ~_.~_~t,_L *n~'~_.'; ..... ~''' "~' ~" -'~
E~amined ./e/~ ...... ,19~ ~ ~ W ~4,'~oc~ ~
Disapproved a/c ..................................... //,~ . ~~]~,
............................. .....
~ ~'~'~¢/ .... ~"7";'f .... ''"ZOW~z %,' 5.
APPLIOAYION FO~ BUILDING PERMIT
Date ................... 19...
INSTRUCTIONS
a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building blSPector, 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
¢. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issua/{ce of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York,/and o'Ibxr applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for rc/moval/01' demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building c/ode, ~/qfJsing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspectior~. ///
........... .................
(Signa_turb of ~oplicant,~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 ...O.~.o/~..d..,~...~..~r..c~...r~.....9-/. ?. ?. ~.t-.. ¢...Q..~.~ .~.L.~..~.~..,~. ....................... (as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) ·
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No...~..~d.~ ..............
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done~
House Number Street Hamlet
County Tax Map No. 1000 Section ll~' Block .... It Lot
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 ~g,~,- {
b. Intended use and occupancy ....... ~..r~.. ?...O. ?.t...f ....... .~ ..M... ¢~'. !tPt',J .....
3. Nature of work (check which applicable): New Building ' Addition .......... Alteration ......
Repair .............. Removal .............. Demolition ..... ' ......... Other Wbrli: .-: ............
v7 1,5 (Desc p, io,)
4.Estimated Cost )
...................................... Fee ......................................
· {to be paid on filing this application)
5. If dwelling, number of dwelling units ......... 0.w.~-.. Number of dwelling units on each floor...0.~..~. ..........
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 .............................
I 1. Zone or use district in which premises are situated .....................................................
1 2. Does proposed construction violate any zoning-law, ordinance or regulation: ................................
13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No
14. Name of Owner of premiSes .................... Address ................... Phone No ................
Name of Architect .................... ; ...... Address ................... Phone No ................
Name of Contractor .......................... Address .... ; .............. Phone No ................
15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... v0
mIf yes, Southold Town Trustees Permit maybe required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or comer lot.
APJPROYED AS NOTED
NOTIFY I~UILOING DEPARTI~T
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING ~NSPECTIONS:
1, FOUNDATION - TWO REQUIRED ·
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O,
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBI'~ FOR
DESIGN OR CONSTRUCTION ERRORS
'ATE OF NEW YORK.
)U Nq'Y OF .... ~o.~.~.o.C..~. .... S.S
..... .'.'.~.O~M....~'..'. ~.u,r/'.c~.'. .O.~.~. ................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
~ve nmned.
is the ............................................................... ': .........................
(Contractor, agent, corporate officer, etc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th.is
,lication: that all statements contained in this application are true to the best of his knowledge
:k~mWillto beforebe performedme thisin the manner set forth in the application filed therewith.,/, /
.......... .Z..a. ....... day of .... .......... 19.Sr. i /
......
ItttrN lC ~ V0r (Signature of applicant)
NOTARY PUBLIC, State of New
No. 4707878 Suffolk Countyo; ~ :
Term L~O t~ Much 30, 1~-.-/.4 [
id belief~ and that th7/~
Rolo
1-own
! I
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