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Home My WebLink About28867-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29211 Date: 01/22/03 THIS CERTIFIES tt~at the building ADDITION Location of Property: 272 BREAKWATER RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 3 Lot 7.4 Subdivision FiledMap No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 25, 2002 pursuant to which Building Permit No. 28867-Z dated OCTOBER 28, 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 FIRST AND SECOND FLOOR DECK ADDITIONS TO AN EXISTING ONE FA~MILY DWELLING AS APPLIED FOR. ·"ne certificate is issued to RICH3LRD T & LORI L BRIGGMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~RALTHAPPROVAL ELEC'~RICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~rKu N/A N/A N/A 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. 28867 Z Date OCTOBER 28, 2002 Permission is hereby granted to: RICHARD T BRIGGMANN PO BOX 850 MATTITUCK,NY 11952 for : CONSTRUCTION OF A FIRST AND SECOND STORY DECK ADDITION AS APPLIED FOR at premises located at 272 BREAKWATER RD MATTITUCK County Tax Map No. 473889 Section 113 pursuant to application dated OCTOBER Building Inspector to expire on APRIL Fee $ 150.00 Block 0003 Lot No. 007.004 25, 2002 and approved by the 28, 2004. Authorized Signature Rev. 5/8/02 COPY 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 For new building or new use: 1. Final survey of property with accurate location of ail 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) hon-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. Ifa 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, Additiolzs to dwelling $25.00, Alterations to dwelling $25.00, 3. 4. 5. New Construction: Location of Property: 2-~7 ~ House No. Owner or Owners of Property: ~-~tClA,thrZD 4 [4~TxZ.[ 'q'~'Cm~'-'l/:~,J t~ Suffolk County Tax Map No 1000, Section [ [ 3 Block O0 "~ Subdivision A~2J-~.-kJ~'~,~f2_V, IQ (~1~,30~) FiledMap.)))))))))~'ad:[~ ?ermitNo. 5Zc_5 (o-7 DateofPermit. Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $25.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ~ Old or Pre-existing Building: ~- (check one), Street Hamlet Lot Lot: Undenvriters Approval: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: b~ (cheek one) 'Applicant Signatur~'t,/ /~-;/;~z .... ,~ TOWN OF SOUTHOLD PROPERTY ~E~.~) ' ....... '. "' ~.A~ . ~'~: : ; ?~.~ . B';" , .~~ /,;.~'.~ ' ~'.~ ~: d~ I Z. ~ -' ~ ' .... IVlOp(lf ~ ~ - ~, ~PE OF BUILDING R~. ~/C~ s~s. VL. F*R~ CO~. LAND IMP. TOTAL DATE REMARKS ,/~< ' CB. MICS. Mkt. Value tillable ~/oodland Aeadowland touse Plot 'otal FRONTAGE ON WATER FRONTAGE ON ROAD DFPTH BULKHEAD M .Bldg( ~ Extension 2~-~ I Extension Porch Porch COLOR Bath Floors Foundation Basement TRIM Rooms ]st Floor Rooms 2nd Floor ~ ~P~/'5~-~t~ Driveway Oo Bo Total ~7~. Dormer . Recreation Roorc Patio Ext. Walls [_~Occ.. ?;.; ~,.,; Interior Finish' ~_~.; Z~c~) Heat Breezeway Fire Place ~ Garage Type Roof Dinette BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: /_~/,~ DATE SUBMITTED:~/,~z SCTM# DISTRICT: 1,000, SECTION: 0~ , BLOCK: STREET ADDRESS: ~.~2 'i~>~-~too~.-t,_~'-~._ CITY: PROJECT DESCRIPTION':'~-~,,- ~Sx~ xo ~..'b . __, LO"i': _ ~,~.Tc ,,Tu e~ I< _ SUBDIVISION' FAST TRACK? ESTIMATED PROJECT COST: q SINGLE & SEPARATE CERTIFICATION-REQUIRED? fl.~' NOTES: - ' LOTS 40,000SF -100-24. Lot recognition (CREATED before June 30, 1983), UNDERSIZED I.OTS FROM JAN.1997 100-25 Me~ger (A nonconforming at any time afte '-~-4o CONFORMING? '~-~ _ACT. LOT SIZE: ~'~I Iq REQ. LOTCOV. 2o'~ ACT. LOTCOV. -' PROP. FRONT ~ REQ SIDE I"~.]~" __ACT. SIDE ~ PROP. REAR ,,," REQ. HEIGHT PROP. HEIGHT ZONING DISTRICT: REQ. LOT SIZE: REQ. FRONT REQ. REAR WATER FROi'fiT? PANEL #: ,//~/ lto DESCRIPTION: FLOOD ZONE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES oG(BED #): DTE: / / PERMIT #:R10- TOWN SEPTIC RECEIPT: Y q~ - NEW YORK STATE DEC: ~,m~4)~c ~n/?s YES or SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES o~___Q.) / NYS ENERGY: YES OR NO : EGRESS (18 H min.? 4 sq total) / VENT(SQ. FT. x4%) ~ _ L. IGHT(SQ. FT. x8%)-/' BUILDING PERMITS OPEN/EXPIRED: BP ~Tg~O -Z/C/0Z- HA~P~CO'S:YORN BPo~,~3~'Yr?' -Z/C/0 Z- NOTES: / - FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: .?~-g SF SECOND FLOOR: /.2~ SF OTHER: SF TOTAL: .,~ ff/_SF 1. ( ~9~z/, SF)- ( SF)= __SF X $ __ 2. (. SF)- ( SF)= SF X $__ =$ INIT OTHER FEE FEE +$ +$ +$ +$ =$ TOTAL FEE =$ 765-1802 BUILDING DEPT. INSPECTION [ ~UNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~*~ ~'/~-_. DATE /0/~ 0 L//iNSPECTOR TOWN OF SOUTHOLD BUILDING'DEP32RTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ / Examined Approved Disapproved a/c 1~, : : * OGT 5 2002 APPLICATION FORBUILD G PE IT i ~ - ~STRUCTIONS BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: 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 fi.om 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 ora 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. ~-~ or nS, ifa corporation) (Signature of applicant 3'0a ¢ ,/q/ qwTx, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~/'~./t~,~]~:> ? ZaP! (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. ~ ~ ~o~2_~/~' /~/ Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section //~ Subdivision ,,4~ t,-~mlt'~: (Name) /Y477/re, c/( Hamlet Block ~ 0 3 ~' .... Lot "-~,,. O~ ~ Filed Map No. g ~ _'~/qq Lot' g . ' o Statcexisting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy og/~ -~//-,~/c'cO' ~ fll~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost /~/(~ ~ 1~) 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Other Work Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Dimensions of entire new construction: Front / ~ ~ Rear Height / 2- ' Number of Stories ~ 9. Size of lot: Front Rear Depth 10. Date of Purchase /--/~q ~ Name of Former Owner 11. Zone or use district in which premises are situated Depth Rear ?d' ' 12. Does proposed construction violate any zon,~ law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO t/ Will excess fill be removed fi:om premises? YES 14. Names of Owner of premises /3/~r~/~ a-~ttV' Name of Architect Name of Contractor ~-~,,4~ ~ ~ 15 a. Is this property within 100 feet of a tidal wetland or a fi:eshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY B,E..~QUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO ~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. No J Address LTL~ e ~A4~ ~'~e No. , q--~'g -t/q~7~ Address Phone No Address~.~q PhoneNo. ~g ~-~~ NO 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 ) ~----~-~~ ~-.~'[z'4 being duly swom, deposes and says that (s)he is the applicant (Name of individual signing confract) above named, (S)He is the . (Contractor, Agent, Corporate Officer, etc.) of said own~ or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statememts 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 (~ O_7'Z-. ,20 O.~ Notary P~lic ~ - ELIZABETH A STATHIS NOTARY PUBLIC, State of New York No. 01ST6008173, Suffolk County Term Expires June 8, ~ ~, NO, DISTRICT: 1000 SECTION: 113 BLOCK: ;T LOT(S): 7.4 POST 0.8'N 1.J3 ocres LOT 24 ]25' AREA: 57,914.4 S.F OR 1.33 ~ LO~TE FOUN~TIO. 4-16-99 UN~U~O~/ZEO ~LTE~nON O~ ~OOmON m T~/S SU~ /S ~ ~nON O~ SECnON Z20~ Ok ~ N~W ~O~K ST~ EOUC~ ~ COP/ES OF ~/S SU~ M~P NOT ~EA~/NC ~E L~NO SUrgeOn'S g~OSS~O SE~ S~L NOT ag CONS/Og~O meg ~ WUO mug C~X ~U~N~gS /NO/C~O ~E~gON S~ ~UN ONLY TO ~E PERSON FOR ~OM ~E SURLY IS PREPARED AND ON HIS BEHALF TO ~E TI~E COMPAN~ GO~RNMENTAL AGENCY AND LENDING INSerTION LIS~D HEREON, AND TO ~E ASSIGNEES OF ~g LENDING INSTI~ON, GUARAN~ES ARE NOT ~ANSFERABLE. ~E O~SE~ OR DIMENSIONS SHO~ HEREON FROM ~g PROPERTY LINES TO ~g S~UC~RES ARE FOR A ~EClFIC PURPOSE AND USE ~EREFORE ~EY ARE NOT IN~NDED TO MONUMENT ~E PROPERTY LINES OR TO GUIDE ~E ERECEON OF FENCES, ADDI~ONAL S~UC~RES OR AND O~ER IMPRO~MEN~, EASEMEN~ AND/OR SUBSURFACE S~UC~RES RECORDED OR UNRECORDED ARE NOT GUARAN~ED UNLESS PH~ICALLY E~DENT ON ~g PREMISES AT THE ~ME OF SURLY PUBLIC WA~R AVAILABLE ~ ~LL WATER ~ INDI~DUAL SANITARY S~TEM ~ ELEVA~ON DA~M: SURLY OF: DESCRIBED PROPER~ CERTIFIED TO: RIC~RD BRIGGMANN & LORI MAP OF: BRJGGMANN; FILED: SI~ATED AT: MATTITUCK TO~ OF: SOUTHOLD SUFFOLK COUNTY, NEW YORK ~' Calver~n, New York 11933 FILE ~ 99--45 SCALE: 1"=40' DATE: APR. 1, 1999 PHONE (51~) ~-51~ ~ (~1~) ~-~1~