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HomeMy WebLinkAbout23868-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24841 Date JANUARY 10, 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 4175 NEW SUFFOLK AVE. MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 4 Lot 34.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 12, 1996 pursuant to which Building Permit No. 23868-Z dated DECEMBER 20, 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 ACCESSORY STORAGE SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to EDWARD & BONNIE ADAMS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A G Bui ding Inspector Rev. 1/81 FORK 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) N° 23868 Z Date .............. .... ..a.......�.�......................, 19...3 p Permission is hereby granted to• .... .... .... ......................... .yr.••••:•.'rr.••�.. ....-••.................... . ....... .. ....................... _ A��aYe r atpremises located at ..................... ...� .... ....... . .................................... ..................................................................... .' .............. .............................................. ................................................................................................................................................................. County Tax Map No. 1000 Section .........../ lock ........y$/......... Lot No. ......� <..�. z pursuant to application dated ................. . .... 9. .�.�....., 19.,,e-.p and approved by the Building Inspector. Fee $.... .�... � ............ ........................................... ................. Building Inspector Rev. 6/30/80 Form No. 6 QQ(2�,dX 6a_1 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 . . . . . . . .. . . . 9 . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .e�. . . Old Or Pre-existing Building. . . . . . . . . . . . . . . Location of Property. . . .� .��. . . . . . . . . .... .. . . ... . . . . . . . .�V. . . . . . . . . . . . ..f/ .P T cf� . . . . . . . House No. Street Hamlet Onweror Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . � . . . . . .Block. . . . ` �I/. . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . 7 .. `2/�. . . . Date Of Permit. . /. . . . . . . .Applicant. . . f Health Dept. Approval. . . . . . . . .Nle. . . . . . . . . . . .Underwriters Approval. . . . . fvl4 . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . .. . . .. .. . . . . . . . . . . . . . . . . . . ��64�'Wv . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Q-&-. 5 -2 Vs. / APPLICANT 765-3802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSyLAT1ON [ ] FRAMING [✓f FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /�VC�� �G - r DATE � � INSPECTOR uR 1,01vi, DA*l V UUMIEtIl", I-'()Iilll)A*I'l ON: 14 1)AT L01.1 ----------- MUCH I-ItAtW tl. y . NTATI; --------------------------- F I IfAl. ----------:--------- ------------------ ------ ------------- ------------- ----------- ADDI.TIONAL ---------- --------------- tT f F 3 ME / rrnler 3 a 'n , ##?yyAA I fl I F II A? Z. IT The The IM Mini Barn MiniBarn rher existing or proposed, axl ilx1icate all set—hack dimensions _____. .,_ .______.. ...,,�.. .__..�. descripticxi according to deed,,arxl rim, street nayes and indir-ale AIC11wr inl.erior or corner lot. `✓i�Al /79 z - is? ul Cow j i a l0 1 L 'lam' 8 tj i .J I l9O: 's �:1I ItJIY (F' -_• �......... -i . -+ —_= a_ :_____ =_-_- c=.- _a.z__ _ - _ _ s _ __, __-_ z. ,._z_d = , .z a_ interior or corner lot. V ' r C \'s 00 = -� e v o STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . . . . . . . . . . BOARD 01" 1113AL'I'll . . . . . . . . . ... . . . . FORM NO. 1 3 SETS of PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . r; pp BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUT110LD, N.X. 11971 TEL: 765-1802 NOTIFY: --_ -1- �� - CALI. . . . . . . . . . . . . . . . . . . EWxnined. ............, 19� MAII, TO: . . . . . . . . . . . . . . . . . . . . Approved. 19_... Permit No_... .. .................................... Disapproveda/c .......................... ... .................................... (Iuilding Inspector) . A .ICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS a. ' 'ibis application must be cenol.etely filled .in by typo,7riter or in ink and submitted to the Ihiilding Inspector wi.l. 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 lxibl.ic streets or areas, and giving a detailed description of layout of property mist be dracwn on the diagram which is part of this applicatioin. c. 11►e work covered by this application ray not be cenmenced 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 wlx)le or in part for arty purpose wliatever until a Certificate of. Occupancy shall have been granted by the Building Inspector. APPLICATION IS 11EREBY 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 Yorir,, and other applicable Laws, Ordinances or Regulations, for the constniction of buildings, additions or alterations, or for removal or cknwlit"ion, 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) . °X d . .. °f� Tee c y/J 5Z...... (hailing address of applicant) State whether applicant, is owner, lessee, agent, architect, engineer, general contractor, electrician, pl.0 ber or iuilder. ...........................12 or) ................ ............ ��a ��•NOT D•` A,�o /3 r✓•� �a,» E' r,�D r7rn S d�ATE: S.PNone of- owner of premises ......... .!.................'..................................— .. (as on the tax roll or latest- deed) FEE , BY: . NOTIFY BUILDING DEPAMTV15NT AT If applicant is a corporation,. signature of c}�fil �ain uirlkoizc<Tt 3 , FOLLOWING�$ �NS. FOR THEter''z"•a� ' '' �^ [h 4 q • . 1. FOUNDATION - TWO REQUIRED (Nam and title of corporate officer) { 61 1� V�P�"1 P FOR POURED CONCRETE ' _ .# 2. ROUGH a FRAllOiING & PLUIVIEING INSU , :...... .E eu VFINALLATI(3 C®NSTRUCTTICDEU MUSTBuilders License No. ........ ��``} tr ' _ '` l4 p BE COMPLETE FOR C.O. Pluci�ers License No. ............. •..:, � (: hf����i�UF t;�, E� �) v1 ALL CONSTRUCTION SHALL MEET Electricians License No. .._j2M._....... THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Oticer Trade's License No. ...... .. ✓rf �, CODES. NOT RESPONSIBLE FOR 1. Location of ].and on which proposed work will be ckme. ` f DESIGN Of CONST�1J9 QU ERF!QRS ............ ! v! .A-1.. ............. . �CGiC...� c'�............... idouse Nurber Street Tlanlet 1 Coxmty Tax Map No. 1000 Section .....j Block ..a 4l':0®..... Lot .. Gam--/0 aac).. '� 1 Subdivision ........ ........................... riled Map No. ./ .lP.�!�.'. _ Lot ............. (Nave) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........h?�.L?�.C .F. / ................................................ In. intended use and occupancy ....... � 1.��' �L..... �.,Sr. "G �? . �..1. i' '?':::............ / U 7. Rifi1rY! of imrk (dieck alricl) al)i)licable): New Ilrril(Iing ..../..... AMiLion .... Alteration Rrl)a i r ............ ItenwaI ............. Ikrml i t ion ... Ol.lrer lk�rk......... ........ .. ...... /� cyz� (Desc:ripticxr) _........ 4. Estimated U)st' ..... �3.9d............ Fe :36m 00 C ..................................... (to be paid on filing this application) 5. if (krellinll, niad)er of (knelling units ............ Rrr1)er of: owelling tinits on each floor ................ if garage, ixsiber of ears ...................................... 6. If Ix)shiess, cOmnercial or mixed occupancy, specify nature aaxl extent of each type of use.......... ............ 7. Wimmsious of: existing structures, if any: Front:................ Rear ............... Depth .......... ....... Ik:ioit Muber of Stories Dimensioos of same structure with alterations or acklitions: Front ................'Rear ............... Depth .................... IleiglrL .................... Usiber of Stories ................ 2• B. Dinensiex►s of entire new ccousLrx.tion: Front ........ ...... hear ....+........... Depth ........_... .. Ileilll►t ............ .7 CT.... Mni)er of Stories ....../� .......... r.� 9. Size of lot: Front .....� �1 T..... Bear .......�.�d'��.. Depth. ..........� ..... 10. hate of Purchase ......................Maxie of Foriwr Otuner ........... .........._.................. II. Zooe or use district in %Aiicli premises are situated ........................................................... ... 12. lkxxs proposed c(x►strx.Lion violate any zoning lava, ordinance or regulation: .......Mg.............. H- Will lot: Ix- regrax)ed .........P�....... Will excess frill be rerx>ved from praiiises: YES 14. Mi)<nes of (kar►er of premises h�?n41A y E© 0019.•+75 Acklress �4+�c?x G�1 M�}Tr'TLc c%� Pf)orne No. Name of Ardiitect .............. ....................... Arklress .......... ..................... PI►one No. ........ ...... Marne of Cxxntractor ................................... A(klress .................................Il lot ve N). ....... ....... 15. is this prnlx!rLy Within -0) feet of a tidal me-dared? * YES .......... a) ..�..... *IF YES, IM111l(I) 7CllM '111I)M TS 11?BMIT MAY lz- RLL)IIIRI?D. 1'1.0'1' DIAGRAM Locate clearly aril distinctly all lx►ildings, wl►ether existing or proposed, aril indicate all, seL-back dimensions f'rmi prollerty lines. Give street aril block n►xiber or descripLion according to deed,,arxl sl►ml street names aixl indicate %Aiedwr interior or corner lot. /7711,6—Se4 190 �' 1dL�nz"/ :t� Simp W ODD Oec4C POO n,1r WAV' 1G' x32 Cj - fs � I srn•tli IUeuJ Sc.��C`�aLfC w�-- -- --- - - _ - - - - - - -- - ---- �.— ss (JIAINIV (R? ... q;(k......... A Ins .......................... .. " ayIx!ing taly rworn eli)ses aailss that he is the appl icant (Nanx! of irxlividtial. signing contract) -Ibove l34rne(1, Ik! is II►e .......... � (U)nLrnct'or, ngenL, corlx)rate officer, etc.) of said owix2r or (mlers, sail is duly authorized.to perform or have performed the said work aril to nvd(e a)xl file This application; than!: al.l. statements contained in !.Iris application are Lr►ie to the bast: of: his kixnwledge null Ixfl.ief; nxI that the work will. be per.l'.onned in Lhe'iirrumicar',set forCh in the application filed therewith. !kmrn to pp I)efore mr9 this , ` .......day of: C.�.. Nol:ary Biblic ..... ............... ... R RT I. SCOTT JR. NOTA PUBLIC,State of N.Y. (Signature of Applicant.) No.4725089.Suffolk Coun Term Expires May 31, 19 ,