HomeMy WebLinkAbout37249-Z gUFFOI,f Town of Southold Annex 6/1/2012
�a� COGe P.O.Box 1179
54375 Main Road
o �5� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35728 Date: 6/1/2012
THIS CERTIFIES that the building SHED
Location of.Property: 1840 STANLEY ROAD MATTITUCK,
SCTM#: 473889 Sec/Block/Lot: 106,740
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/14/2010 pursuant to which Building Permit No. 37249 dated 5/24/2012
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:
accessory shed as applied for.
The certificate is issued to VICTOR&LYUDMILA MOUZYKIN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Aigorized Signature
�guFFO<,�
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
P . 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#: 37249 Date: 5/24/2012
Permission is hereby granted to:
VICTOR & LYUDMILA MOUZYKIN
1840 STANLEY ROAD
MATTITUCK, NY 11952
To: CONSTRUCTION OF AN ACCESSORY SHED IN THE REAR YARD AS APPLIED FOR.
REPLACES EXPIRED B.P. # 35502
At premises located at:
1840 STANLEY ROAD MATTITUCK
SCTM # 473889
Sec/Block/Lot# 106.-7-40
Pursuant to application dated 4/14/2010 and approved by the Building Inspector.
To expire on 11/24/2013.
Fees:
PERMIT RENEWAL $50.00
CO -ACCESSORY BUILDING $50.00
Total: $100.00
97)/;,
ildin Inspector
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. 35502 Z Date APRIL 23 , 2010
Permission is hereby granted to:
V & L MOUZYKIN
1840 STANLEY RD
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN ACCESSORY SHED IN THE REAR YARD AS APPLIED FOR
at premises located at 1840 STANLEY RD MATTITUCK
County Tax Map No. 473889 Section 106 Block 0007 Lot No. 040
pursuant to application dated APRIL 14, 2010 and approved by the
Building Inspector to expire on OCTOBER 23 , 2011 .
Fee $ 100 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
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 nets 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. "Sw-orn statement from plumber certifying that the solder used-in system contains less than 2110 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
I. Certificate of Occupancy- New dwelling.$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00, Accessory building$50.00, additions to accessory building$50.00,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 cupancy -Residential $15.00,Commercial$15.00
Date_
New Construction: Old or Pre-existiri�g Building: (check one)-
Location of property:
House No. Street Hamlet
Own6r or Owners of Property: 9yj pC[� �y `�1 out y�
Suffolk County Tax Map No.1000, Section f D 6 Block % Lot 7 U
Subdivision Filed Map. Lot:
Permit No. 3 -7 °2 ff�f Date of Permit. s " ZLf ' ( Z Applicant:
Health:Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Lo
Applicant Signatur
OP SOcou
(/j�,olo
3
TOWN OF SOUTHOLD BUILDING DEPT.`
765-1802
INSPECTION . .
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.-
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFEWINSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
a
6
DATE INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS �
FOUNDATION(1ST)
- -- -------------------------
FOUNDATION(2ND) �1�7
• z
ROUGH FIIAMYNG&
PLUMBING
INSULATION PER N.Y. H
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
N
0
� z
L'
V
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 Survey
www.northfork.net/Southold/ PERMIT NO. s �?�a— Check
Septic Form
N.Y.S.D.E.C.
Trustees _
Examined 20_v Contact:
Approved ,72.0�a Mail to: Victor Mouzykin
Disapproved a/c 1840 St1840 Stanely Rd,Mattituck,NY
Phoned
Ex iration 20_
DC E 9 V A_ �
-Building Inspector
APR 14 2010 APPLICATION FOR BUILDING PERMIT
Date April 12 2010
BLDG.DEF INSTRUCTIONS
TOWN OF SOUTHOLD
ST be completely filled in by typewriter or in ink and submitted to the Building hlspector 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 ofbuildings,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)
1840 Stanely Road, Mattituck, NY
(Mailing address of applicant)
State whether applicant is owner, lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
Owner
Name of owner of premises Victor&Lyudl'nila Mouzykin
(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:
1840 Stanelv Road Mattituck
House Number Street Hamlet
County Tax Map No. 1000 Section 106 Block 7 Lot 40
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 n/a
Y b. Intended use and occupancy Storage Shed
3. Nature of work(check which applicable):New Building ✓ Addition 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 n/a _Number of dwelling units on each floor n/a
If garage, number of cars n/a
6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. n/a
7. Dimensions of existing structures,if any:Front n/a Rear n/a Depth n/a
Height n/a Number of Stories n/a
Dimensions of same structure with alterations or additions: Front n/a Rear n/a
Depth n/a Height n/a Number of Stories n/a
8. Dimensions of entire new construction:Front 12' Rear 12' Depth 16'
Height 12'-8" Number of Stories 1
9. Size of lot:Front 121.25' Rear 121.25' Depth 165'
10.Date of Purchase n/a Name of Former Owner n/a
11.Zone or use district in which premises are situated R-40
12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO ✓
13.Will lot be re-graded?YESNO ✓ Will excess fill be removed from premises?YES—NO
14.Names of Owner of premises victor Mouzykin Address 1640 stanely Rd,Mattituck Phone No.
Name of Architect Nemschick Silverman Architects Address 160 Main St,suite 200 Sayville 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 Suffolk )
Victor Mouzykln being duly swom,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the Owner
(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
l t- day of 20 10
Notary Public Signature of A plicant
VICKI TOTH
Notary Public State of New York
No.01t06190696
Qualified in Suffolk Count
Commission Expires July 28,zu[
Southold Town Building Department
O��FfOL�C P.O.Box 1179
Permit#: 34792
54375 Main Road
o ` Southold,New York 11971 Permit Date: 6/17/2009
(631)765-1802 Expiration Date: 12/17/2010
Parcel ID: 106.-7-40
BUILDING PERMIT RENEWAL LETTER
Dated: 5/16/2012
Applicant: VICTOR& LYUDMILA MOUZYKIN
Location: 1840 STANLEY ROAD MATTITUCK
Work Description: DECK
CONSTRUCTION OF A DECK ADDITION TO AN EXISTING DWELLING AS APPLIED FOR.
A FEE OF $200.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT.
Owner: VICTOR& LYUDMILA MOUZYKIN
Address: 1840 STANLEY ROAD
MATTITUCK,NY 11952
The permit listed above has expired. Please contact our office as soon as possible to begin the renewal
process. All work on the project must stop on the expiration date.
No work is permitted or authorized beyond the expiration date.
THANK YOU,
SOUTHOLD TOWN BUILDING DEPT.
�osIJFFQk Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT
0
E
g FORM
Ol PROPERTY LOCATION: S.C.T.M.#:
��� �� THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A'
—� STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN
District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
——————————————————————————.————————————————————
Item Number: (NOTE: A Check Mark(4)for each Question is Required for a Complete Application) Yes No
———————————————————————————————————————————————
I Will this Project Retain All Storm-Water Run-Off Generated by a Two(2")Inch Rainfall.on Site? ;
(This item will include all run-off created by site clearing and/or construction activities as well as all Site —
Improvements and the permanent creation of impervious surfaces.)
2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size&Location? F-1
This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlow! —
3 Will this Project Require any Land Filling,Grading or Excavation where there is a change to the Natural F-1
Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? —
4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of ❑
Five Thousand(5,000)Square Feet of Ground Surface? —
rj Is there a Natural Water Course Running through the Site? ❑
Is this Project within the Trustees jurisdiction or within One Hundred(100')feet of a Wetland or Beach? —
6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen(15)feet of Vertical Rise to ❑
One Hundred(100')of Horizontal Distance?
7 Will Driveways,Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off ❑
into and/or in the direction of a Town right-of-way? —
8 Will this Project Require the Placement of Material,Removal of Vegetation and/or the Construction of ❑
any Item Within the Town Right-of-Way or Road Shoulder Area? —
(This item will NOT include the Installation of Driveway Aprons,)
9 Will this Project Require Site Preparation within the One Hundred(100)Year Floodplain of any Watercourse? ❑ —
NOTE: If Any Answer to Questions One through Nine is Answered with a Check Markin the Box, a Storm-Water,Grading,
Drainage&Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit!
----------------------------------------------------
EXEMPTION: Yes No
Does this project meet the minimum standards for classification as an Agricultural Project?
Note: If You Answered Yes to this Question,a Storm-Water,Grading,Drainage&Erosion Control Plan Is NOT Required! —----------------------------------------------------
STATE OF NEW YORK, r
COUNTY OF. I: d�,).fC....................
That I, 1 . 6( {<S I ` being duly sworn,deposes and says that he/she is the applicant for Permit
............... ..
(Name of individual signing Docume )
1
Andthat he/she is the .................................. .�L ......................:...........................:................................................
(Owner,Contractor,Agent,Corporate Officer,etc.)
Owner and/or representative of the Owner of Owner's,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 herewith. .
Sworn to before me this;
........................1....`.................day of... ....... .. ..................... ,20LQ
c l ,,,,, NubIcs�aQp . aw Yo . . . �Notary Public: ... Notary P 2A!5 ��II ...........i.
UY 6 (Signature of Applicant)
Qualified in Suffolk Cour
FORM - 06/07 4U/e
TOWN OF SOUTHOLD PROPERTY RECORD CARD
yo
OWNER STREET E VILLAGE DIST• SUB. LOT
M ka &,e,7,C-- ce
FORMER OWNER 9�b�tr`('Z.,�r N E ACR.tL
u s ,v• l': " S W TYPE OF-BUILDING
RED. SEAS. L VL. FARM COMM. CB.- MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
d--fl ✓ 1 7G s r; f �'
!! 0 �.�`: l t Z .QL6 ' �.: sz�o -`� -�•5 o
Q Sf a o 1.
d o 0 -L _� 5 - � � un n� o r�rl rtr z : - o2so,Oda
kt%w cjwr-
OS--U
i
AGE BUILDING CONDITION
NEW NORMAL � BELOW ABOVE
RARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Wcodland FRONTAGE ON ROAD
Meadowland DEPTH "
Home Plot f dD0 7 c� BULKHEAD
Total DOCK
■!�!!■■!!!1■!■■■■��■■■■ice
- - - - - NO!!�E■!i■!■!■■■i■!!■■■■■M
■!E■■i■■i■■■i■■i
MEMISIMINMEMMISM ENSUE
MMEM
■■■■®ui■■i■o■i■!!■■■!■ MM
■■i■■!■r■ii■■!illi■!iIS®®■iMEN
J . _ _ _ . = : ■■lDlDi�■�■« �■ SOME■■
= i■■■ice!■■■�i■■■■■i!!■!B
Air
Fire P
IType
■■
.. . -
a
... e�
Recreation Room Rooms . ., !!
---------- ----------
5-10 114 5'-10 11401
SITE INI=OR'MATICN
MOU7111KIN RE51DEZE 5EC TION: /06 A5PHAL T ROOF 5HIN57LE5 12
1640 5TANLE)e RD. BLOCK. 7 TO MATCH HOUSE. 15#
MA TrI WCK, w LOT,• 40 FELT PAPER OVER�"
ZONINC5 : R40 CPX PLYWOOD 5HEA TIN57
LOT OVER 2X6 RR 1611 D.G. 12
DE5CRIP REQUIREMENT EX15TINC, 2x6 FJ 0 /6 Oz. 2x6 FJ a 16'ac. 2x6 RR 0 16'o.c.,_
TION 2x4 CHOR�x_ /6 N 0.C. 12
MINIMUM LOT 51ZE 40,000 3F 20,006 5F
2x6 CJ /6 N Oz.
ACCE55ORY5TR61157WE (PM tar_54&20p00-AqkM_5F)
DE5CRIPTION REQUIREMENT PROP05ED R, 2x6 RR 6 A T.O. PLATE
MIN. 51DE AND/ 47 ELEV 7'-O"
OP REAR YARD
50BACK 2x6FJ@16"ox.�, 2,y(, FJo1(5No.c.,__ 2x6 CJ 16 O.C.
MAX HEIGHT
NEW 51,91N5 TO MATCH
HOY5E. Q
TYVEK PAPER OVER
EL (55.o) CDX PL'rHOO,9. 2X4 5W
0
X U1\11;1A_ 7 /ON fpL AN O.C.
_CAE114' /'- N ' (2)2X6 PT F05H HDR
P-0
ANCHORED 5ON07I)BE PLKkY000 5U9FLOOR
OVER 2X(q FJ /(5 O.C.
HITH 6IMP50N COLUMN
BA5E.
A FF.
3
(31 5HED05ED I O
`9J ELEV O,Faa (56.0)
6RADE I I I I
14
aEV-0 LJ-17) LJ LJ
A5PHAL T ROOF 5HINOLE5
TO MATCH H00E.
12",e 50NOTZIBE MIN. 3---------
BELOH GRADE
4vELEV 7'-O`
55.0 25'-Oy
NEW 5/DING TO 5CALE= 112' = /'-O"
Cy MATCH HQU5E.
o 15TY FRAME 6ARA6E
EL (.,55.5)
W CELLAR
Ph a (57.o)
5le
20.0' I FF.
e_
EL (55 a aEvol-off
COVIEREV PORCH, 4 GRA
DE
A,9E
ELEV-( 42')
51 _ V TION
5CALE = 114" /'-O'
5 71115q20 121.25' A! L
in C�17 TtiE
C`,`�DEIC 0
3TI ANLEMIR0145
&5 07 EAF EF P�_L_A A/
565ALE P 20'-0' __7 kT
Ah F.F. FF. O�la1
11V ELEV 7'-Off 9-,'aEV 7'-C`"
U1 S E i S U11 NLAVV
!r A -7
OF,jT
NEW 5/DING TO rA 1 4. F
MATCH HCV6E.
F
THE
F0r,
FF. jk FF. 7N 1 -10
ctl TRUCI
7L aEv o,-o,, aEV O'-ON
GRADE 4P OR,4 IRE
1--'
ELEV-0-129 ELEV-0-129 nil
DCOR5 SEA -.QED ARC REVISIONS/SUBMISSIONS: DRAWING TITLE: 10 1 U
RAMP ,W &
DATE: DESCRIPTION:
-flTf- PLA/1, FLOOR PILA/ly
LLEVATIO/jj&jr-CTIO/I
R,5A 9 Eil_=5- VA T 0 N
4 OAT
5CALE = 114" = /'-0" 5CALE= 114' x /`-O` Or N ILE NAME:--------
PROJECT TITLE: DATE: NSA PROJECT
Nemschick Silverman Architects P.C. PROP10jr-P ACCVj0RYj7RUCTURr 04/09/10
the business of ARCHITECTURE."
1840-/TAILr-Y ROAP SCALE: DRAWING NO.:
MATTITUCK, tV
430 Green Way, C utchog ue, New York, 11935 Af IiOTEP
Phone : 631-734-7007 Fax : 631-734-7347 DISTRICT: SECTION: BLOCK: LOT: DRAWN BY:
,
http://NAr"w.nt-->-arch ,.c,-c:)m
*COPYRIGHT 2D10 NEMSCHICK SILVERMAN ARCHITECTS P.C. 1000 1061 7 40 YR)