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HomeMy WebLinkAbout37374-Z s,aFFC011: , Town of Southold Annex 7/25/2012, " 7-- P.O.Box 1179 <. 54375 Main Road oy Southold,New York 11971 " Via! tea° CERTIFICATE OF OCCUPANCY No: 35844 Date: 7/25/2012 THIS CERTIFIES that the building SHED Location of Property: 625 E Side Ave,Mattituck, SCTM#: 473889 Sec/Block/Lot: 99.-3-15.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/5/2012 pursuant to.which Building Permit No. 37374 dated 7/19/2012 a'- was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy f6r which this certificate is issued is: "as built"shed addition to existing dwelling as applied for. The certificate is issued to Keller,Richard&Janice (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut ed Si ature s�FFns� TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o . SOUTHOLD, NY y�pl Sao~i 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 #: 37374 Date: 7/19/2012 Permission is hereby granted to: Keller, Richard & Keller, Janice 625 E Side Ave Mattituck, NY 11952 To: "As Built" Shed addition to an existing dwelling as applied for At premises located at: 625 E Side Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 99.-3-15.1 Pursuant to application dated 7/5/2012 and approved by the Building Inspector. To expire on 1/18/2014. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 Building Inspector 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 neiv building or neiv-use: 1. Final survey of property with acctimte-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.2l10 of 1% lead. 5. Commercial building,industrial building,mtiltipte residences and similar buildings and installations,a certificate of Code Compliatice-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 C°pr-e-existing" land'uses: 1. Accurate survey of property showing all property lines,streets,building,and.unusual natural or topographic features. _ 2_ A properly cpmpleted application and con-sent 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-Nevi dwelling$50_W,Additions to dwelling$50.00,Alterations to dwelling-$50.00, - Swimming pool$50.04 ; Accessory building$50.00,Additions to accessory.building$50.00,Businesses$50.001 2. Certifieate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of.Occupa icy-$_25 4. Updated Certificate=of Occupancy- $50.00 5_ Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 'Date. " . 2 vew Construction: Old or Pre-existing Building. (cheek one) 1,oeation of Property.: ,* /n a`J 'S­`­&Q House No. Street �. Hamlet owner or Owners of Property: ;uffolk Eounty Tax Map No"1000,Section Block c Lot ►ubdivision filed Map. Lot 'eltmit No. �J D y Date of Permit. r -) Applicant: lEealth Dept.Approval: Underwriter's Approval: -Tanning Board Approval: request for: Temporary Certificate Final Certificate: (check one) ee Subimued: $ Sep •°Ofx.y L o Applicant Signature SO(/r�, cOONi`1,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . ,.. [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS �1'1ON [ ] FRAMING/STRAPPING -�FlAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGHV [ ] ELECTRICAL (FINAL) REMARKS: a DATE 7 LINSPECTOR FIELD IlVSPECrXON REPORT DATE C011AIENTS FOUNDATION(IST) rA FOUNDATION(2ND) W O �1 ROUGH FRAMING& �I PLUMBING LA ' M Yr � y INSULATION PER N.Y. STATE ENERGY CODE —I Cs zz FINAL ADDITIONAL CONIIENTS ' C 71) o z �m N . tdsi 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 Plansp L TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. 3 Check 7f Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Examined 20 �� Single&Separate Storm-Water Assessment Form Contact: Approved 120 Mail to: Disapproved a/c Phone:C5 D I r� I Expiration I1,20 A VECEW Building Inspector UL - 5 2012 E 0APPLICATION FOR BUILDING PERMIT BLDG.DEPT. Date , 20 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 pen-nit 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. t a N"' CERTIFICATION.OF b s �, E Signature of applicant or name, if a corporation) NAILING & CONNECTIONSti REQUIRED. ��u ,� � �' (Mailing address o0applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises APPROVED AS NOTE (As on the tax rolbATL�tea7_B P # If applicant is a corporation, signature of duly authorized officer FEE: Ic&-0 NOTIFY B(Name and title of corporate officer) DEPARTMENT 75-1802 8 AM TO 4 PM FOR THE , Builders License No. 6 8NING Plumbers License No. TNAL- CONSTRUCTION&ELECTRICAL Electricians License No.. NUSiT BE COMPLETE FOR C.O. Other Trade's License No. HUXTMAL ALL CONSTRUCTION SHALL MEET THE y INSPECTION EQUB 'L- REQUIREMENTS OF THE CODES OF NEW rr YQRK STATE. NOT RESPONSIBLE FOR 1. Location of land on which proposed work will be done: JR�p 0 TRUCTION ERRORS. House Number — S_treet -` ''t Hamlet County Tax Map No. 1000 Section Block Lot 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 b. Intended use and occupancy 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 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 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 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone No. 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 * 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. ram ,•;;': .'.i}-, ; i'_. '7 .•,,..,id''.s 17. If elevation at any point on property is at 10 feet or below, must provide topographical•data onsurvey,.. 18. Are there any covenants and restrictions with respect to this property? * YES NO IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) -- -- " being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notary Public,State of Nra, s, (S)He is the No.01 BU618505 (Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk Cc,. Commission Expires Ape l`l,�.•aal of said owner-or`own&r and is duly,authorized to perform or have performed the said work and to make and file this application; that all statements.con.t amed�in this,-application are true to the best of his knowledge and belief; and that the work will be performed in lhe,l ai�rl.el,set,fgl`th its th/e application filed therewith. y:t,4•, .JJIJf,JYS{,�C��....� !{Y�• Ml/l. Sworn to before me�Glu =sl;ti`:!.•. _ 54+x day of 20 Notary Public Signature of Applicant A/�, ���97 , \� CONC RETAINING CPy \g` cP WALL +I Y TCI .� leg•„ FR STORY'19..• 4ME No USE VS'w m _ 2n4STORY WOOD DECK Q 49r INSET 'k0A9V0 1"= 50 Op 9V D�oN�F I 4f 4s EAS\ 4C y4V�N s//p OR rn 2�.E 3/pF \ D D A�- SEE INSET N 2 STpiN FRAME A GppAGElUNOER �I �, C £� CONSTRUCTION, NC, highway Per RET4 1N1 W4L� 1 9 1o �— P hway record _ - / srl pN\ _--k -1 FRAME HOUSE ! 7'_—r— r Or O6CN `rI Ip 1? `Ire CM I a 2na STY .. OECIT WOOD fR 5 f_ \� ti _ ,` VI/ Acres ��\ now or formerly pp 1 \ v�\ Lot 4 �\ Robert D Stearns et al. 1 U4jn/ST O C9c gRERBEp \ b�\ o d I �� m 'O l � A! vi n+p/• rO D'w \Vl-- LAMO WA r/ LIMIT OF- • 84 09- f y , r�... Matti fuck New 19Z�1 York S/o Park le District SUFfaLJC COUNTY DEPARTMENT OF HFALTM SER111IES SIUrovD"l"otYco oor siLY Date UCT H.S.W.No. The 119vra9e dlapoasl and waWr cup,y fe mws Sit 049 tocatlon 91avc,b T.- Inspoci«rand/or oerit W by Rka Voprarbn,'•:,r other agencies and found to ue sausfatpory. NOTE, �� ELEVATIONS SHOWN HEREON ARE _ St phen A.Costa,P,E.,Chlel REFERENCED TONGV.D.(MSL 1929) -�RiCe0lWeterandWa9teW&tOrM81444 @li1ef14 SURVEY FOR KNUTE BYSHEIM AUG 4 1993 JUL.26:1993 AT MATTITUCK DATE: JAN, 14,1993 TOWN OF SOUTHOLD SCALE I°= 100' SUFFOLK COUNTY, NEW YORK NO. 93-020 MUNAUTHORIZED ALTERATI ON OR AD DI T ION M THIS SURVEY f A VIOLATION 7 E CTIDN T209 OF THE NEW ATE EDUC I LAM E M COPIES OF THIS SURVEY NOT BEARING THE LAND O SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL W, j• NOT BE CONSIDERED TO BE A VALID TRUE COPY M GUARANTEES INDICATED HEREON SMALL RUN ONLY TO 97 HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY I!PREPARED -k AND ON AG BEHALF TO LENDING TITLE INSTITUTION LISTED M NEAREST WATM DIM MI, MSOUN CE OF WATER:23-- O_PUBLIC_ MENTAL AGENCY AND LENDING IS or THE ON DING M SIIF CO.TAK MAI OlTTd00 Sf CTION 099 BLOCK Si LOT Ie.I HEIIEOI,AND TO THE ASl IONfEs OF THE LENDING M THEM ARE NO DWCLLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION.GUARANTEES A IINSU TRANSFERABLE Q. OTHER THAN THOSE SHOWN HEREON. TO ` Q M THE WATER SUPPLY AND SEWABE DISPOSAL SYSTEM FM THIS RCSIDENCZ OWNERS WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT M DISTANCE! SHOWN HEREON FROM PROPERTY LINES TOExISTING STRUCTURE! ARE FOR A SPECIFIC C.. �. APPLICANT-HEAL TH SERVICES' PURPOSE AND ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRESS TEL YOUNG ei YOUNG RRHE DA ,NEWYORNKE NOTE: •=MONUMENT FND.0=4*x4'POST FND. ALOEN W.YOUNG,PROFESSIONAL ENGINEER RE; LOT NUMBERS,EAST SIDE AVENUE 8 NORTH LAGOON LANE AND LAND SURVEYOR N Y.S.LICENSE N0,ENGINEER ARE SHOWN ON SUBDIVISION MAP OF°OLD MILL HAVEN CO"FILED12845 IN THE SUFF,CO.CLERKS OFFICE ONOCT,2,1925ASFILE NO.T99 HOWARD W.YOUNG, LAND SURVEYOR *THE LOCATMINOF WELL(w),SEPTIC TAHKIST)e CESIPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NG.45893 ARE FROM FIELD O&MAMSTIONS AND OR DATA OBTAINCD FROM OTHERS BRANDIS A SONS INC.1046 Insula-Dome Skylights 83 Horseblock Road Yaphank,New York 11980 631/924-7890 Fax 631/924-7870 www.insula-dome.com 1� ,L Ct7/�aa�ds ul�/l l L: N Ask Us About Our NEW INSULATOR II GLASS M �} o l i 112 p &E D CON�S-1 TOW A—J p t C-�c6 _S h�l ate at S)A'r 1 lM be cvp -- G -n a) � �-��k viol, a �- �w caw_ r All W 0 d d L,4- k ; rn �`,r 6(-> `iU lam� Vn t h I Yn rNt�l �. _ 11) oY` � x, -o- CA J» ii cA h GCc�A YLa w; V?g2, 2 , r 1 r S �� -.__ � ill 2 x 12 ic>zx vo- wall ct bd koadoAr l © czP60015 P a i Ce al ez-,oluwi, inn t ,, I t(LU P-� lhOs walls nkr �try�a i pa i Y- ca r i CV 0 0r��-A 6.14 AQ rr r� TA) 1T V?, L� �.e I d d p -� :Z4 OY' all !A�C,05b 111"/-A -!�c J � 6 lon v a r r S 1 \ 1 ' L sy �Y 1 OA - &� 16 , - w 3, V� ',� .� �► , - ClJ -- _ � I " 1 } _ ? 4ac� '� � , �- #�� � -��"� _ - ` :a r ) i`. } �i - - 1' � .. ,� � �� �-� - :, -�:,.__ , '� / + ,� ,�► . - �;,� t -�` .� „ , ��� S_` i ' - S � I lot s i i `"4 j