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42161-Z
p�SUffO(,�coG Town of Southold 12/11/2017 y!Z P.O.Box 1179 C3 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39397 Date: 12/11/2017 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 2200 Wickham Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 139.-3-25 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/15/2017 pursuant to which Building Permit No. 42161 dated 11/20/2017 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, including renovation of kitchen and bathrooms, air conditioning and gas heat and hot water heater, in an existing one family dwelling as applied for. The certificate is issued to 2200 Wickham Ave Fmly LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 17-37070 11/1/2017 PLUMBERS CERTIFICATION DATED 11/27/17 n a Piecu 0ut oriz d Sighlure, a�SvfFnc,r�oTOWN OF SOUTHOLD ay BUILDING DEPARTMENT TOWN CLERK'S OFFICE o . 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#: 42161 Date: 11/20/2017 Permission is hereby granted to: 2200 Wickham Ave Fmly LLC 13235 Main Rd Mattituck, NY 11952 To: - legalize "as built" alterations to existing single-family dwelling as applied for. Additional certification may be required. At premises located at: 2200 Wickham Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 139.-3-25 Pursuant to application dated 11/15/2017 and approved by the Building Inspector. To expire on 5/22/2019. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $420.00 CO -ALTERATION TO DWELLING $50.00 Total: $470.00 B ding In. ector 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: 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. 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. November 15th 2017 New Construction: Old or Pre-existing Building: V (check one) Location of Property: 2200 Wickham Ave Mattituck House No. Street Hamlet Owner or Owners of Property: Trent Preszler Suffolk County Tax Map No 1000, Section 139 Block 3 Lot 25 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $ Applicant Signature Certificate of Compliance ...................... ................................ ........................................................................................................ ............. CERTIFIED ELECTRICAL INSPECTIONS, INC. 188 PARK AVENUE AMITYVILLE, NY 11701 P: (631) 598-5610 .... .... .... ..................................................................................................................................................... CERTIFIES THAT Upon the application of Upon premises owned by Trent Preszler Trent Preszler 2200 Wickham Avenue 2200 Wickham Avenue Mattituck, NY 11952 Mattituck, NY 11952 Located at: 2200 Wickham Avenue, Mattituck , NY 11952 Application Number#: 17-47070 Certificate#: 17-47070 Electrical License#: Section: 139 Block: 3 Lot: 25 Building Permit#: Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Maintain -Air Conditioning/ Kitchen / Boiler Conversion /2 1/2 Bathrooms 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/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 1 st day of November 2017 Name QTY Incand. Fixture - 15 Amp, 120V 15 Smoke Detector- 15 Amp, 120V 3 Switch - 15 Amp, 120V 12 Exhaust Fan - 15 Amp, 120V 3 Dishwasher Circuit-20 Amp, 120V 1 HVAC Blower- 15 Amp, 120V 1 Carbon Monox-15 Amp, 120V 2 HW Heater Circuit- 15 Amp, 120V 1 Electrical Inspector: Anthony Giordano ® DD ':APPROVED;n 1 V 1 3 2017 .............:... EJ MDING DEBT. �'O OF SOOZO This certificate is not valid unless raised seal is present. Certificate of Compliance .......................................................................................... ... ..................................................................................... CERTIFIED ELECTRICAL INSPECTIONS, INC. 188 PARK AVENUE AMITYVILLE, NY 11701 P: (631) 598-5610 .. ............................................................................................................................................... . . ...... CERTIFIES THAT Upon the application of Upon premises owned by Trent Preszler Trent Preszler 2200 Wickham Avenue 2200 Wickham Avenue Mattituck, NY 11952 Mattituck, NY 11952 Located at: 2200 Wickham Avenue, Mattituck , NY 11952 Application Number#: 17-47070 Certificate#: 17-47070 Electrical License#: Section: 139 Block: 3 Lot: 25 Building Permit#: Name QTY AC Condenser- 30 Amp, 220V 1 Duplex Receptacle- 15 Amp, 120V 5 GFI Receptacle- 15 Amp, 120 V 7 Electrical Inspector: Anthony Giordano .APPROVEDo This certificate is not valid unless raised seal is present. NOV 1 3 2017 BIDING DEPT. Tovv»®F souTHo .D Town Ball Annex �- Telephone(631)765-1802 54375 Main Road Fax(6311.765-9502 P.O_Box 1179 = Southold.New York 11971-0959' �Q BUILDING DEPARTMENT TOWN OF SOUTHOLD •CERTIFICATION Date: -7 I-7 Building Permit No. Ha 1 (0�1� Owner: IJl/�` ,C�, /#I (Please print) Plumber. 'LCu Ch (Please print) �ti4 I certify that-the solder used in the water supply system contains less-than 2/10 orf 1°lo. lead. (Plfimbers Sigt aiwre) = Sworn to before me this C®NIVIE D.BUNCH' - I Notary Public,State of New York day ofv� 20 No.01 BUfi1 X5050 Qualified in Suffolk County Commission Expires April 14,2�� Notary Public,SU� County SOUT�olo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ VNSULATION FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRIC#L (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS/Il�t/ JIA� 5Ot4k!L QW /6) U#, (Am Preov 4 gqf[A - LS y� DATE - ! INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS • � b FOUNDATION (1ST) ------------------------------- FOUNDATION (2ND) z ® � kp ROUGH FRAMING& ®. �] PLUMBINGCA � r INSULATION PER N.Y. H STATE ENERGY CODE FINAL ADDITIONAL COMMENTS O z m �r t� _ H rr O z H d b H 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 Surve ( ) / y SoutholdTown.NorthFork.net PERMIT NO. (� 7Check I Septic Form N.Y S D.E.C. Trustees C.O.Application Flood Permit Examined 204—j� Single& Separate Storm-Water Assessment Form Contact: Approved20 Mail to: Robert Wilson Disapproved a/c PO Box 49 Southold NY 11971 Phone: (631)504-8842 Expiration 20 _R D 9Ea V [a D B pe n ctor NOV 1 5 2017 APPLICATION FOR BUILDING PERMIT BUILDING DEFT. Date Nov. 15th 120 17 TOWN OF SOUTHOLD INSTRUCTIONS a. This application 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 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) PO Box 49 Southold NY 11971 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Agent Name of owner of premises 2200 Wickham Ave. LLC (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: 2200 Wickham Ave Mattituck House Number Street Hamlet County Tax Map No. 1000 Section 139 Block 3 Lot 25 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 1400 square foot existing 2 story house. Same with interior repairs, and remodel of existing kitchen and 2nd floor bath. b. Intended use and occupancy Addition of powder room off master bedroom 3. Nature of work(check which applicable): New Building Addition V 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 1 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 24'-3" Rear 24'-3" Depth 33'-7" Height 24' Number of Stories 2 Dimensions of same structure with alterations or additions: Front 24'-3" Rear 24'-3° Depth 33'-7" Height 24' Number of Stories 2 8. Dimensions of entire new construction: Front 24'-3" Rear 24'-3" Depth 33'-7" Height 24 Number of Stories 2 9. Size of lot: Front 100.00' Rear 100.00' Depth 149.28' 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated R-40 Medium density residential 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V 13. Will lot be re-graded? YES NO V Will excess fill be removed from premises? YES NOS_ 2200 Wickham Ave 14. Names of Owner of premises Trent Preszler Address Mattituck NY Phone No. (631)294-4241 — 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 V * 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO_� * IF YES,PROVIDE A COPY. STATE OF NEW YORK) CONNIE D.BUNCH S: Notary w York No.01 BU6180 0 COUNTY OF64 OuaNfied in Suffolk County . Commission Expires April 14,2 `� Robert Wilson being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the Agent (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. Swornbefore me this of NDVS LVV 20) Notary Public Signa6e of Applicant Scott A. Mussell , �® Ir ST01KMWAk T]E1K SUPERVISOR MAN SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 ® Town of Southold d � CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOLES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) ❑® A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑® B. Excavation or filling involving more than 200 cubic yards of material within.any parcel or any contiguous area. ❑© C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ®® D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑FZ1 E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑® F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control PIan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT (Property Owner,Design Ptofeasional,Agent,Contractor,Other) S.C.T.M. #: 1000 Date District NAME- Robert Wilson 139 3 25 11/15/2017 > 1 Section Block Lot "°l ****FOR BUILDING DEPARTMENT USE ONLY**** [contact Information (631)504-8842 fraumoaN m, Reviewed By: Date. Property Address/Location of Construction Work: — — — — — — — — — — — — — — — — — 2200 MITI Rd. Approved for processing Building Permit. El Stormwater Management Control Plan Not Required. Mattituck NY 11952 Stormwater Management Control Plan is Required ® (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 Town Hall Annex jam` '- Telephone(631-1802 S4375 Main Road s, Fax(631) 734-9502 P_ O. Box 1179 CZ' cry {- Southold.,NY 11971-0959 ,rr- BUILDING DEPARTMENT NOTICE OF UTILIZATION OF TRUSS TYPE_CONSTRUCTION, PRE-ENGINEERED WOOD CQNSTRUCTION AND/OR TIMBER CONSTRUCTION Date: November 15th 2017 Owner- Trent Preszler Location of Property.2200 Mill Rd. Mattituck NY'1r1952 SCTM:1000-139-3-25 Please take notice that the (check applicable line): New residential structure V Addition to existing residential s(rticdre Rehabilitation to an existing 'residential structure to be constructed or erformed at the sc�b'pct roe refer nce above will utilize (check applicable line): ,aJ Truss type construction (TT) Pre-engineered wood construction{PIIV) No structural .. rhanges . Timber construction (fC). in the following iocation(s)(check Applicable line): Floofframing, including girders and beams (F) 1 Roof framing (R) Moor and root framing (FR) Signature-- Name.(person submitting this form): ` RobertWiitson Capacity(checkapplicable line)- Owner —V Owner representative i 7russResReo,i 5.ciocx Effective-111/2015 SURVEY OF LOTS 29 AND 30 MAP OF MA_TTI TUCK HEIGHTS SITUATE AT MATTITUCK - TOM OF SOUTHOLD SUFFOLK COUNTY,NEW YORK 15 8 D 15 30 45 60 75 90 105 120 135 �• ° SCALE 1"=30' DATE:APRIL 30,2015 J all LOTAREA:16,303 SQ.FT.=0.420 ACRE G .10 f • N65�' �° .- � es:�� ,mow 9� -.F Tom, CERTIFIED'TO. CARROLL HARVEY JOB NO 2015-170 sq &' L0� MAP NO. 1184pry -FILED JULY 24, 1935 a ' REVISIONS: ` 9 • L0l 2 Of pµfp$8' c1p 215 NpNotE PA�p►N pP Jap N� SEN \ gca o ORS PNP LICENSE NO 050363p,R9 Rceetr� rma�isrO� HANDS ON SURVEYING e � mw nr�rc,aaa.�,mnarune u"lami®mvo"`�OP6i„e 26 SIL VER BROOK DRIVE FLANDERS,NEW YORK • 11901 ,ten TEL:(631)-369-8312-FAX.•(631)-369-8313 MARTZN D.HAND L aS mwcawtmsaxc _ em°nm�swtran COPIES OF THIS SURVEY MAP,EITHER PAPER OR ELECTRONIC,NOT BEARING THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BEA VAUD COPY AND SHALL NOT BE USED FOR ANYPURPOSE P � �^ k664 COMPLY WITH ALL CODES OF Additional NEW YORK STATE & TOWN BODES OCCUPANCY�OR Certification AS REQUIRED AND CONDITIONS OF tAP ROVED AS NOTED USE IS UNLAWFUL May Be Required, a .. _ s TROUT CFL ,��,� ,,�� DATE: B.P. NSInT IAiAIrn • �nA+nonnRp WI F t 11 1, +�.�' I -! WF c e�A ��f: - saeWN- s OF OCC UPAMCY �N 1 NOTIFY B'L. >iE T AT 765-1802 8 AM �.,r,vi FOR THE 11 fp-ppi, r 3~ MA T FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED ELECTREICAL FOR POURE!? "CNCRETE INSPECTION REQUIRED � 2. ROUGH - PLUMBING 3. INSULA? ev Fula- 1 4. FINAL. - MUST + BE COM, ALL CONS► SHAD. MEET THE REQUIREMt • THE CODES OF NEW ' YORK STATE. AOT RESPONSIBLE FOR 3• DESIGN OR CONSTRUCTION ERRORS. r R I� - R„ ,OFF - RETAlN STOR��A 1•,1� , R CIO. .®. FURSUAidT TO Ctil ` L 3� OF THE TO't,V G _. �.l..l+�M�1 Itis�'r ��.5.��,. �:��C�,.��►N�_.-..:._t►�.'�"..5_.�----•----•-. .- .. Irwigra WALL E FLED qq r h 1 o Q� NIGEL ROBERT C4,cv.144"t 72 OF EW rT IS A VIOLATION OF THE I, LAW FOR,ANY PERSON, +, I,� I®•• UNLESS ACTING UNDER THE I DIRECTION OF A LICENSED - ARCHITECT,TO ALTER ANY ' j ITEM ONTHIS•DRAWING IN L ANYWAY.ANY AUTHORIZED + ALTERATION MUST BE NOTED,SEALED,AND DESCRIBED IN ACCORDANCE �1 ��l�__ is LsQ.IJ__ _.___�_-_•_______� _-_._ WITH THE LAW. 5 _.T: 13� .® � " _��s�_.tom" ®� rS �: d