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Home My WebLink About23514-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24738 Date NOVEMBER 15, 1996 THIS CERTIFIES that the building ADDITION Location of Property 75 OAK PL. & 1200 FACTORY AVE. MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 142 Block 1 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29, 1996 pursuant to which Building Permit No. 23514—Z dated JUNE 18, 1996 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 2ND STORY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to TIMOTHY & DOREEN SEYFRIED (owners) of the aforesaid building. . SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION CERT. #13260 DATED OCT. 7, 1996 PLUMBERS CERTIFICATION DATED N/A u' di Inspector Rev. 1/81 FORM NO. f 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) Nos 23514 Z Date .............. . ........................................ �9... .. Permission is hereby granted / .........L�.. .C�./..`E'.-d.............. .445..2... ..............K......................... ... . .�.� y ../Iee:c�YK.............y...l . �`��/ to KK� ......f at premises located at ... (16�: � . — P..:.... ° 61 / ........................................................ ... . .. ..... .................................... .............................................................. c ...................................................... County Tax Map No. 1000 Section .......1 ...'. Block ........... ........ Lot No. ..l................... 6VW pursuant to application dated ................. %....:� ........ 19...!Nl' and approved by the Building Inspector. T Fee .�t. .......� .... .. ..................... . . Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 a 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 - .251�, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . .GI . .7/e .6 . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . .. . . . . . . . . m ti Location of Property. . . . . . . . . . . . . . . . . .��. . . .��. . . . . . . . . . . . . . . e.`�. . House No. Street Hamlet Onwer or Owners of Property. � � .��. . . t f�. . . . . .. ,, j mod, , , , , , , , , , , , , , , County Tax Map No 1000, Section. . . .: V. . . . .Block. . . . .' . . . . . . . . .Lot.. . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . : . . . .Lot. . . . . . . . . . .. . . . . . . . . . . . Permit No. 1.�. .�.11ate Of Permit. . .4°.,1 ��. . .Applicant '_2�\ . . .1.�MOl -Sng I.4 Z Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval.tv . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .�. . Fee Submitted: $. .?-�. � . . . . . . . . . . . . . . . . . APPLICA „ co � y� 3 / :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::: ::::::: ::::::: :::::: ::::::: ::: ::::::::::::::::::::::::::::::: _ _ _ E,:E .:?RII :PE T `EING ................................................................................ _......L....C......... 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B�II.DX.tY�sPEM '. .................................................. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::...l...... ....................................................................... ...........................................................................................................::::::::::::::::::::::.:::::: .:::::::::::::::::::::::::'::::.::::::::::.....ee 6...iiia:be ideii6fii�b:':fL'eic¢edeiifials::::::::::::::::::::::::::::::::............:: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::....................... ??.sP.......................:::":::::y:::::::::'::::::::::::::::::::::::::::::...............:::::....... :::::::::::::::::::::::::::::: .. :. C Pl.........I:P.Qvw.OBFICE:::::::::::::::::::::::::::::::::::::::::::::::::::::::_:::::: ::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: _...BEUE.OI�IGINAh......YELLAW...Cp......_........_......................_..._... ......._ ...._.._........................... c 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 7ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ �INAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ` INSPECTOR ors-iso2 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FO NDATION 2ND [ INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: F!cic�� o� DATE INSPECTOR // ,� FIELD INSPECTION REPORT DATE COMMENTS ----------------- FOUNDATION - ( 1ST) Ij it — FOUNDATION (2ND) II 'd, ROUGH FRAME & — co ir-------it _ PLUMBING li II INSULATION PER N. Y. STATE ENERGY CODE — u I II I - u I' FINAL �— I ADDITIONAL COMMENTS: led o vu 1 -- -- x H ' fl ,� MiTE_H _ LfiVE P At SEE .3Ec NO t41 u AI • �• o. • �a a� pf a �. +_ _ �lGN A. e. BOARD OF HEALTH .- - - - - - - - - • - n FORM NO. 1 3 SETS OVLANS - FORM TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . :Mi� �/ BUILDING DEPARTMENT CHECK .� . AY 2 9 TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 BLDG. DEPT. TEL: 765-1802 NOTIFY: pp p TOWN OF SOUTHOLD CALL a?.g4l .I.p . . . . . . Examinee- , 19�'` -� MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.: / ., 19.;' Permit No.' ...J f .�. .................................... Disapproveda/c .................................. ..................................... ............................................. ..... \ ilding Inspector) AP CATION FOR BUILDING PERMIT .Date. . . . . . . . . . . . . . . . . 19. . . . 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be comienced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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. APPLICATIrN IS HEREBY MAIZE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the T(xm of Southold, Suffolk Canty, 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 nece ary spect• S. / r ` .... .. ......... (Signature of - licant, or f a corporation) .. ,..�- -.a. ... :3........... (Mailingaddress of applicant) r T uL le� /1-/ / //9<'I— State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......:................................................................................................................. Name of owner of premises .---`•/ o- /7!.. .. �.Ll ! ...................... ...................... (as on the tax moll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nam 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............................................................... .......75 .................c?.AA...��.��...................,/.`O��I.T./��t.......... J•.... House Number Street Hamlet Canty Tax Map No. 1000 Section ...� :CJ.C1 Block ..../.�?v..... Lot ..C?0...1.��.�.�•� Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and/intended use and occupancy of sed construction: a. F�sting use and occupancy ....... !.!�.��° (��...,..e� /L ...... ( :. LG, /Jvi......... b. Intended use and occupancy ......... ...�!" . .../•,',r..........,l.C. d Uv................... . .. ....... I Mature of work (dieck whido applicable): New Njildinp. .......... Addition . ALtera�.ion Repai r ........ Renxyval ............ Demol it ion ............ Other Work ....-f• ', .o•U�,-..�!Pe, �oQ! (Description) 1/7 4. Estimated Cost .'.�_G._.. fee ................................ (to be paid on filing this appliicatibn) 5. If dwelling, rnni)er of dwelling units ......I_... llid)er of. A401ing units on each floor ....!" '..... 1'f garage, rxnber of cars ....... //........................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use......101-........ 7. Dimensions of existing structures, if any: Front...... .... Rear .3. .. .... Depth ..-� �1�J$ lk.ight ...t0................. Nuttier of Stories ....0.............. Dimensions of sane structure with alterations or additions: Front ..... . .4'. Rear 3 Depth .........RE /.... height .......22:�.._...... Nuii)er of Stories ... ........ 1�> 8. Dimensions of entire new construction: Iront ...3.g. 0 .... Rear .. .�.... Depth ��--Z....... 61 lleiglit ..2..3._... ........ Niniber of Stories ... ... j h6 9. Size a ]ot: Front ��Iar ............... Depth .................... 10. Ilaite of Purchase ..... _� .. __.__. Name of Fanner Owner I.?g�9.�/7!<�®/.t.�J 11. Zone or use district in wiiidi premises are situated .....lC J.f.D.4.N .. / ..............................� 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ,`�.......:.... 13. Will lot be regraded .......N..a....... Will excess fill be removed from premiiises: YES (NOD f i7v /a d- o!� 'Eu A L'd 7.. .4`•ll. r C a t nNo 1 i. Names of Owner of p/revises/. ......�T .�.. .�. Address _. .U-. ..'l1/�?�1/. Phone .-7. .. Name of Architect L.�S� �!�//�/4> l,��aU�S�.&5tg�V �/')A4 r(!ggd ..5A 7'1l1>46 No 24 _ Acklress J- Name of Contractor :/.`,fy � _..... .. Acklress 6,0?,�.5' �r t:��c.c_.... .Phone No. noLr-V I' -..... rho u) -- - /1� �/ 15. Is this property within 300 feet of a tidal wetland? * YES .......... �I�1.../. •, j `G *rF YES, S(XMXX.n MM 1RI1MES PEI3Mrr MAY Bc- REQUIm. ✓ �3 q—�,D / PLOT DIAGRAM Incate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block rxni)er or description according to deed, and show street names and indicate Miether interior or corner lot. [, /�Ni� G r 13 6Z U1•'U ,y(,q 13 S / 7y C 6 UA / Y rAy1.11f,P No /00 � �- 3� ] /3Ldcn al G b GA2A3� �7U�lSE / M'XI, 01. raw Y0tW.- SS --•-----•• - -. '== {- l- _•-per- �� -being duly sworn, deposes aril say ll - -• •� s that be is the applicant (Nave of individual. signing contract) aline ium ed, le is Llie ..............to�4 0/............ (ContracLor, agent, corlx)rate officer, etc.) of: said owner a owners, and is duly authorized to perform or have performed Lhe said work and to make and file Lhis ahhlicatirni; that all statenents contained in this application are true Lo die best of his knowledge and belief; and Lhat Die work will be performed in the m nner set forth in the application filed therewith. Sworn to before me this ...... 14. k..day of Notary I'olblicl ...._..... (� ..� .... ........ ✓✓ ELI2.A:9E3F1 ANI+1 NEVILLE ( igruiLure of App[.icant) Notary Nbllc,State of N:--w York No. 52-8125850,Suffolk Cour,�/ Term Expires October 31,19 . J r 7 ...£-. WRITERS CERT{FICA7E - s . .IM.M^ EDI .. .. ,REQUIRED S .p®p�TO CODE;. - 014 BE ORE' I � - } � I t t tt i' i ! la 'JJi^E!+-kin fii / S .-ttor:r r`.hc N�:'Ym �An`,•o i _ 1ti - - --' - - • - fo b va U:52fcn__ :3ica id h a T eh ,.)tin 7 c� an :o!;a „son h rn the suve ^•is aetae9d. d en hi;�wshah is t ie . � 1 ''-� .., % t3!?�.^Silii(:2n/.•'!OV::tt�t:i07Ttsi H�;2{:Cy9Y'� . i is irlaatudon IMed'IArson antl r f _ to tho as,;:pnaas cf tha iand4rKj ineti- - ZW!On.4itu':ari yg are not tran3'fslrWa 1• . i m<:c'-1 nstitutiors or su �iquont � J i ti_i ��G ..-__! = J' .. _ 'f -.• i .� t ;.' r� - t f •,t ''f � cri _ '-'-f F .r r%/,),°!:�^._ (/`''�.. C r.• �- fF r - •_.j f J _- Sf' �✓ .. f � 1•f..•( .. S .. ✓�✓Ji� +:J rf *. ��')err �{ r' p r_ — t i t ..� :ma's - .' :i 1• �:-a ! ", .., /.ma's_ _ J .... ,..,.-.._._ , :..+-/'ti.--�.!' r, ,� •-s� - 1' 3 : . WDERSMITM CERTIMATE 4 fEQUMED r .g, pS '�l q I {p p Y r .r « _. ._ .a .... ._._._... —.,_ m„A w k r ...._..,,—_•r-.+....-_...- -_ .._...._.,.._,_- .."._._.» .. .-._......w.,_._... .._ � _...-..._._.._...._,V__,.......-.....« ,+..___._,..•:_»..�__--.-•._.-.` - -- __ - L R w �Q I_ k yy +'7 � 3, TEv 7. Apl� Eb , .ntn IR I � 7 9 •'°ii s i 3 �u w.P # f, r- R _.. r� By. P, F 7 77 ti I' ---_.__._..._ - (J __ __. _. __ �. _.._ ,_Y_. _ --- _ _ _.. . z NOTIFY (3K1lL Ca DEP PAl` 6 1 FO TH 7 5 8t72 � T Q' PM 0 FOLL.O'i,11fIIVG INSPECTIONS: , 1. FOUNDATION - T491O REQUIRED FOR POURED CONCRETE I 3. _ •_.__.._'_ .e_._.- - -- _ .. . _ .,. . .-,,. I ` 1i _.- _., __..._..,__._. .. FRAMING & LUM LA BING 4• FINAL - CON STRUCTIiON MUST r _ . RE COMPLETE ALL NSTRUCTION SHALL MEET IME REQUIREMENTS T OF THE N.Y. - --- -- ::_::_ STAVE CONSTRUCTION & ENERGY CODES. N RE SPONSIBLE RE PONS LE FOR DESIGN OR CONSTRUCTION ERRORS i I 01, _ r • r 1 I _a r — ° e0ol)," E. 4 F, VAT ) D f\J L; t _ : s I i ► Cj ►-- _. 0 N) F ,HT FLF:-V-/6Dj VAT I DM I fl - --•___ . � -� is----- ___ ,. ._ . ,._ _.. , �=._._�--`- f _.._.i,.i r M n SE ` FR) E D -RE7'-E-� t�'ENJCrE-- ` SCALE DRAWN By iECM A . ' . _ - a •fY/ 4 S a " REVIIS..�E'DD EL E VAT'1 0"S ^S N or[- d, � rvCM {/rKlr ALL LFM PJSIO�,3 ��JG C�+lJAI`#`10�Jl� „S5.36�"1AY,W�•po PDX 16n,6�J�!`�tJ wf ile, DATE APPROVEp BV DRAWING NUMBER - � • �i4...ri...+�49jS�7!RCJ -MJIRA.J Y� 24x36 MADE IN U.S.A. A,q TQCT5'STANDARD FORM - , 2442 24` Z r . PROVIDE 0"Etl1f:"S f0^ EMECGENCY ESCAPE AS REQUIRED Cy PART. 714 OF � � � �►, �A,�t� I .Y. STATE 0111DiPGCODE. 41 N I � r E , `1D68 SL, % � + _._.FRo- lq- x 1 2X�o�5 fib" dC NUAJ j k I S PROVIDE OPEF:IE,GS FOR REQUIRED QY PART. 714 OF ' N.Y. STATE RUILDIF�G CODE, 21 V1 j t" } V � .� n � , zKlm's ►le' OC, HUtik>t FROM 4't1�C,e � ''` a 't 1 ztiti2, zyyz 'i C. J } -71FL -.-N.E.�A.4 ah o 00 / C' .....a_.•, _ ia4a Y SiL� - n ySCALE DRAWN B YC � !/ `G � " REVISED .; �^•irt"' r ai`." t.9 r' ,�.' � er","'""P!,. ,Jr'}' �i .l�a f','if.Jj�t°�"p'�R,;3',y 3f�4WlSt8J1YWW MAD 1'PQtMUn'WMWIlYtyTJ�t DATE VArpRawED By 'AWING NUMnrR _ a , + . .. „ . _ _ J . .. - •. ?a,e�r�-sue . ' � '4 �'r-` • . �i��'� - 2 a�' � . 9 ,�;far..CRYSTALE'Nk'V-!24x76 .. , - - - - ._ - - , - MADE /N U.S.A.. K4 ARCHITECTS'STANDARD FORM - - - J t i I ( �J I , IAI j ( ( i { (. :. _ 1 �• �••-s- -_ - _- 3 ?A$ rZQOF A$ - ><<:S 2Y,IQ� IP 7�i(. a>,Q. Rom 5► nr�r,nlc� C 7 t<o"a,�. - -- Zx4 i�AF r tZ t'Ltti� ABQJ>` sT0. RW�tt- Or1 _` `I •� I _ _, _ j � � /� '�'-ly !NS \ TOP qF C�ILIN� "$Of-"""� f A%( A WRMIP17b tN AwM. ILI i • } I GI V) ( i _ MTW SEGO►JN FLOOR i 12�y•o C es �; I -----R-r, I�nF; 1�.SS 1 R f --vs'Y FF-Cr �J1� 4 w5 MIN, Sol �p �a�t-ir� I p,• { T ;, I IV I4 " E i rJ NEW f -t,SCNT\ f 2 1 ' S � i -= - -2."P.0• `MAP } A } •�� I rc.4�'s f 2.�r' a.� i �xt sT I rJc WAU. i 1 - t T 10 LST ) M �~ " u _1 ;J1 ""'E #'Me`fib - 4 �—) E Y F, 1 I rE � FFS � �EWCE .BAST i1 ` SCALE DRAWN BY - fh F REVISED FX/'ST/AJ(y F t_ QAT1OhJ JOT "; 1FV h � -of- (J l�,{"1 �'.1S ' - :I:*UMgU.1'Vt,•W AI D'M Wx*n SOLMMI)KY 11171 DATE APPROVED BY DRAWING; NUMRPR 1z�52 ins ov-28 �9" I `i' 8 = r MAbC. 11/ U•g A, 'ARCHITECTS-STANDARD FORM '