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Home My WebLink About22979-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23859 Date SEPTRMEER 7, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 12425 SOUND AVENUE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 3 Lot 39 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 15, 1995 pursuant to which Building Permit No. 22979-Z dated AUGUST 30, 1995 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 AN "AS BUILT" ACCESSORY SHED IN THE REQUIRED REAR YARD OF A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to SHARON LATSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector 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) Date ............ ...... ................. 19.�..... NP 22979 Z Permission Is hereby grant�9 �. e> ��V �......�..... .....?� .. .. .... ..... ......I.......... ...a6d........ ...... ............................................ to ..;�Y............ . ......... L- ... ....... .... . ... . ... .. . 1 -...... /r �i .. ............ ...1 . ................................................................................................................. ...................................................................s ,. ...... ......................................................... at premises located at-........... .� ............. .�Sf�� .... ....................I.................. ............. .............................. ... . . ......... . .... .................................... ............ County Tax Map No. 1000 Section ........`�.�./.. ... Block...... .............. Lot No. .�..1................... pursuant to application dated .............. 19.... and approved by the Building Inspector. Fee$. ............. .... ............... Building Ins p for Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD f1 j q�S01i1 BUILDING DEPARTMENT 5 j RJR TOWN HALL 765-18O2 - �,�`rI,'. -,'-`--`-�h`=e'� f':ARPLICA•TION 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: I . Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Appr.Dval 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 Mess than 2/10 of 1.7. 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. I 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00•, Commercial $15.00 Date . . .Augcurst- J,1y. .1995. . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. 11� ?5: o•undr�A� nue, ,TIatt� tucl�, , �Tew, .ygx�c , , 1�9.�2 . ... . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . .Sh�tF ol3 .,C. L tso n. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ::ounty Tax Map No 1000, Section. .141 OQ . . . . .Block. . .U,Pf) . . . . . . .Lot. .Q39. .0.00 . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F.il.ed Hap. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Sharon C.Latson by Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. C.. Xogg.ins- lealtli Dept. Approval. . . . . . . . . . ... . . . . . . . . . . . . . .Underwri.ters Approval. . . . . . . . . . . . . . . . . . . . . . . . . 'lanning Board Approvol. . . . . . . . . . . . . . . . . . . . . . . . ;tequest for: Temporary Certificate. . . . . . . . . . . Fiiiatl Certicate. . . . . . . . . . . d1w&W 7 . ee Submitted: $ . .25 . D0 . . . . . . . . . . . . . . . . . . . . . FIELD INSPECTION REPORT DATE COMMENTS {I II ro FOUNDATION ( IST) — — FOUNDATION (2ND) —� �I ------------------------- -------- ------------------------- II {j — — ------------ ROUGH FRAME & if-----�I --^— — — PLUMBING a {{ I, II II {{ INSULATION PER N. Y. {I tji STATE ENERGY II CODE — I I J� Ile 42 , r� II H II {j FINAL { O --------------ADDITIONAL COMMENTS: Q Pd \ H w r r� 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ =NAL TION [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: Z�o/ 4 1..4 DATE INSPECTO r FD OF, HEALTHEALTH . . . . .i30�1 . . . FORM NO. 1 J SETS OF FL.1?tS . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CiIECt: J TOWN HALL SEPTIC FORK . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 — -- TEL.: 765-1802 11,0 I F-Y ; I.xarniired _-= e4��5� CALL �.7.�' :7.�... . . . . . . . . . Approved . 19�f. Permit No. /.`. . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . Disapproved :r/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ? (Building [uspe or) . PPLICATION FOR BUILDING PERMIT Date , Augus.t 14 , 1995 19 INSTI` UC 1.0NS 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 properly must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to tile, 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 hart for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS I-IEItEBY MADE to the Buildutg Department for the issuance of a Building Permit pursuant to the Building lone 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 necessa inspections. Sharon C. Latson by Vi•11:iam• •G: Goggins. (Signature of applicant, or e corp . 'or P. O. Box 65, Mattituck , ew Y r 11952 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . OWNER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nance of owner of premises . . . . . . Sharon C. Latson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . I'lunrber's License No. . . . . . . . . . . . . . . . . . Eiectrician's License No. Otlic" Trade's License No. . . . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed work will be done. 1.2425, ,S9uji.C.Aypp.lA Matti tuck, -New York 11952 Ilouse Number Street I I'll uulet . . . . . . . ... . . . . . . . . . . . . • Courtly Tax Map No. 1000 Section 141 . 00. . . . . . • . . . Block , 03 . 00. . . . . . . . . . . Lot . . .039 . 000. . . . . . . Subdivision . . . . . . . ... . . . . . . . . . . . .'. Filed Map No. . . . . . . . . . . . . . . Lot (Name) . ... . . . : . . . . . . . . State existing use and occupancy of premises and intended use and occupancy of proposed construction'. a. Existing use and occupancy b. hilended use and occupancy 3. Nature of work (check wlticl► applicable): New Building Repair . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . I . . . . . . . . Removal . . . . , , , • • . . , • , Demolition Other Work . (Description) 4. Estimated Cost . . .� , . , • , , . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . ... f •`�`°�:. . . . . . . . . . (to be paid on (iaang t1iis 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. Di)►►ensio►ts of existing structures, if any: Front . . . . .. ... . . . Height Rear . . . . . . . . Depth . . ... . . . . . . . . . . . Number of Stories 1)in►ensions of same structure with alterations or additions; Front • • . • • . " 1)el�tli . . . . . . . . . Rear . . . . . . . . . . . . . . . . ionHeight .r . . . . : . : Numb ories 8. Dimensions of entire new construction: Front Rear • • • • • Ileigl►t Depth . . . . . . . . . . . . . . . Number of Stories 9. Size of lot: Front . . . . . . . . . . Rear. . . . . . . . . . . . . . : ... . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date ofl'urc Purchase . . . . Name of Former Owner 1 I. Zone or use district in which premises are situated , 12. Does proposed construction violate Any Toning law, ordlllflnce Or regulilt!(?n: . , , , 13. Will lot be regraded ' ' ' ' • • ' ' ' • • . . Will excess fill be removed from premises: Yes No .' I. Name of Owner of premises . . . . . . . . . . . . . . . Address . . . Phone No. Name of Architect . . . . . ... . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . I'1►o►te No.. . . . . . . . . . . . . . . . . Name of Contractor Address . . . . . . . . . . . . . . Phone No. . . . . . . . . . . 5, Is Lhi.s properly within 300 feel of a tidal wetland? . *Yes. No. :1:1 *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whetlie'r existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether nlerior or corner lot. 40 A., 'Y R; � ANC RPR Ea AS NorE® DATE: BKE P # j,7 22 7� z UNUM � FEE: NOTIFY BUILDING ItITa'O, T 9R T I F I I Ar �L-1302 9 �,t1,9 TO 4 F� FOR TQ�E FOLLOWING INSPECTIOINIS: 1-7 01—SIP "' Y 1. h("�UNDATIONi. - T111/0 REQUIRED 111, b I FOR POURED CONCRETE 2. ROUGH FRAMING & PLUMBING 3. INSUt.ATIOlt, 4. FINAL - CON.STI4UCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR [DESIGN OR CONSTRUCTION ERRORS TATE OF NEW YORK O ,r� S.S UiTl OI� . . . . . . . . being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) )ove named. eis the . . Q5 2�?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )plication; that all statements contained in tl►is-application are true to, the best of his knowledge and belief; and that the ork will be perforated in the manner set forth in the-application filed therewith. vorn to before me this . . . . . . . . . . o day of. . . . . . . . � . . ., 19 otary Public, : County JOYCE M WILKINS . . . . , , Notary Public,State of New York No.4952246,Suffolk County (Signature of applicant) Term Expires June 12,19 N / 0/ PENNY GEORGE N /0/ F 100 STATE OF , , o37 ujQc NEW YORK 1,,�� N ,74 1 17' (i oPH 0). O w CO O p ' O_ T GN m o ` m T Z J t>rl' Pck a,hr`e s- cr m o o 'o 00 j• cone D . ?� frb Z conerp +~ SP is`. D m 1 co 1 O o 1 go O p 1\ 1 70�. ,OO,w 77 .30 3 7 � 46 . 60 7003 �n. $. i 1n, A\1 . CERTIFIED TO FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK SOUTHOLD SAVINGS BANK JOHN L ATSON SHARON LATSON SURVEY FOR ,, ws JOHN a SHARON It'ATSON AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N .Y. �Q 4AND S� 1000 - 141 - 03 - 39 ?� �QNI►. IryGF9L� SCALE 1 = 40 o AUG. 5 , 1986 �.: �► gee LIC . NO. 49668 P CONIC O I R S a ENGINEERS P. C. Prepared In accordance with the minimum ( 516 ) 7 6 5 - 5020 standards For title surveys as established by 0. B 0 X 909 the L.I.A.1.S. and approved and adopted MAIN ROAD for such use by, The New York State Land SOUTHOLD j N . Y. J 1971 Title Association. RA - 44 A