Loading...
HomeMy WebLinkAbout22245-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23270 Date OCTOBER 7, 1994 THIS CERTIFIES that the building ADDITION Location of Property 1600 SOUND BEACH DRIVE MATTITUCK, NY House No. Street Hamlet County Tax Map No. 1000 Section 99 Block 1 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DULY 19, 1994 pursuant to which Building Permit No. 22245-Z dated AUGUST 9, 1994 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 A PATIO ROOF COVER TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DONALD G. WITSCHIEBEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A t�tdind Inspebtor 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....... ... N° 222451 Permission Is hereby granted to; V 1 ........ ..............:............................. ......................... 1.. ....... ........i .� .,. ......ram.-..�.�..... . .. ......... ..r.. �, .. .....S.rN. / ....... l.. ............. LJ ..1..(....�. .. . ......... . + ........ . ..... Q. ................... .................................................................................................................................................................. ...................................................................................................................... .................................... .. at premises located at........., ,��....... �? /1�.. '� �C/.1..... ......................................... .....................................................�/ z' ..t..�.�ck.............. .. .......................... County Tax Map No. 1000 Section ........192....... Block........../............. Lot No. .s/.................. pursuant to application dated ...............` .... --.�` .......1 ram..., 19..c.7,,...., and approved by the Building Inspector. C-12- Fee$..... .. ..... F .. .. Building Inspector Rev. 6/30/80 U I� r— Form No. 6 TOWN OF SOUTHOLD OCT •' 6 IM BUILDING DEPARTMENT iL TOWN HALL BLDG.DEPI. 765-1802 A �.l TOWN OF SOUTHOLD 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. - )u_iL 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 Buildiniz - $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 . . .en2ft . 4. l f. . . . . . . . . . . . . . . . . New Construction. . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. AD.©0 . . 4d V.+..Q . . 4 'a.9. . .Q f L1f! . . . . .Al.?T.T. f XP10?. . . . . . . . . . . . House No. - Street Hamlet 0 01YOX0 (-, W JT_V& ff1X_i9Aff G4ONTOW QV,91_JrJ&0 Onwer or Owners of Property. XA.A. P1yRd. . AL�*4.1Ah""Xr_k . T.fl.;: , , , , , , , , , , , , , , , , , , , , , , , , , County Tax Map No 1000, Section. .17.7. . . . . . . . .Block. . ./. . . . . . . . . . . .Lot. . .j . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. .Filed Map. . . . . . . . . . . .Lot... . . . . . . . . . . . . . . . . . . . . Permit No. � .'y:�.:Z. . .Date Of Permit V 4vv.,4. �5`0 ApplicantP.0A 6A WITAC.#All :ly Health Dept. Approval. . . . . . . . . . . . . . . . .. . . . . . . . .Underwriters Approval. .i' . .•� - . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .,--__ . . . Fee Submitted: $. , ? , ,� , , , , , , , e ug J . . . . . . . . . . . : . . . . . �. .L . . . . . . . . . . . . . . . . . . . . . C' APPLICANT o��S�ffOL��oG 0 Town Hall, 53095 Main Road y Z Fax(516)765-1823 P. 0. Box 1179 W Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 23, 1994 Mr. Donald B. Witschieben 1000 Sound Beach Drive Mattituck, NY 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $25.00 'No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 22245-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ass-iso2 BUILDING DEFT. INSPECTION . [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ l FRAMING [LJ��1rAL REMARKS: dz EZ a DATE' d'I IN8PECTOR '~"� 765-1802 BUILDING DEFT. INSPECTION ( ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REM KS: ca�z'� �'i DATE � INSPECTOR rSPUILDING DEFT. [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ j FOUNDATION ZND [ ] INSULATION [t�]'FRAMING [ ] FINAL REMARKS: r_ -DATE �� INSPECTOR .� f� COMMENTS II -v m H )U11DATI01I � � � �.( 1 s t) .:i• :.'.. C Q is . ... . .)UNDATION (2nd ) _ _ CA cA • l� .�. cO z UCH FRAME - •PLUNBIIIGrn rn SULATION PER N. Y. I • . H STATE ENERGY II CODE `•. •FINAL I LIZ -- _ ADDITIONAL COI•f�fEI.ITS : x • x H O I • r �3r.�_!_+�+-_::..ice ti�t`,._L:..iL--,i:.•r :-..•r l��ti:31 �• •►t•�..- � .. .. .. _ .. -- Nl i4 , BOARD ' OF HEALTH . . . . . ... . . D V FORM NO. 1 3 SETS OF PLANS . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . _ _ _ _ . . . . . . . . . . . �gg� BUILDING DEPARTMENT CHECK - • - - - - - - - TOWN HALL SEPTIC FORT! _ . . . . . . . . • . . • . j� SOUTHOLD, N.Y. 11971 U�it/t1•J V�i.7sC iirt� �y BLDG. EPT. TEL.: 765-1802 t:OT I FY q TOWN OL® CALL �.rf p� L� -A Examined . . .C. _ 1 MAIL T 0 . . Approved . . . � - �`P©� • ��?.h� PP . . ..�. . . . . ., 1 Permit Note. Disapproved a/c . . . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . ilding Inspector.) APPLI A ION FOR BUILDING PERMIT Date J . -J� . . . . . . ., 1990 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 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 Inspe'ctor'\will issued 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. 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 necessaryy inspections. ...^�^�ii� v x �r,• S .:�•.„iti ... .aV�lc:i iY��S/ ��•. .� ?'J''^•. I,���'�!�% ,1L/. (Signature of.applicant, or name, if a.c rporation) a y Y (Mailinaddress of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer; general contractor, electrician, plumber or builder. . ... b 1'�.ly�,�. . . . . . . . .��,`/fAitb . '�': 'irJ"'r•r.�c t/Jk:'��'r�7. '�r�F7t�.��. . .����.j.�.`�.� . . . . . :. . . . . . . Name of owner of premises .r)2; q-qH i, . .Iy.krul?gX.(r g Z�l✓�'.% . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . . . . . . . . .. . . .. . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . ... . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . l.r.®.�. . . . . . . 4.01)Np . . ►��.f�.ctl � �?j'C. . . . . ... . . . . . . . . . . . T'?.0 K Y. . .r'.l House Number Street Hamlet County Tax Map No. 1000 Section . .q•q.7 . . . . . . . . . . Block .f . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . 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. Intended use and occupancy . . . . . .T /O I Port 0 -3. Nature of work (check which applicable): New Building . . . . . . , Addition . . �°�.�.��Alterai:ion-,:. ' Repair . . . . . . . . . Removal . Demolition, Other Work . . . °7 • • • (Description) 4. Estimated Cost . . . . . . 1J •.�•®. . . . . . . . . . . . . . . . . . . Fee . .(.� . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on.filing•this.'application) S. If dwelling,number of dwelling units . ... . . J ''' : .:`' • Number of dwelling units on each flooi J. If garage,number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of•each typ. . . use ... • • • • 7: Dimensions of existing structures,if any: Front ff�. W P j. ; �y AI Rear Depth • Height. . . . . . . . . . . . . . . . Number of Stories .t?J'f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front Rear • • . . Depth . `WA ...y°�,�; . •AkAN. . . Height . . . . . . . . Number of Stories PJ�rc. . . .. . . . . . . . . . . 8. Dimensions of entire new construction: Front . 1.61.1Rear 4�.Y:r,57,(J>l G; /,D! Depth . . .J.?r .Height . . . :�.! Number of Stories /}! ' ' ' ' ' ' 9. Size of lot: Front 1. {� . . . . . .... . Rear. . . . . [ 10. Date of Purchase . ! . . . .Depth � 11• :1 ,L . . . . . . . . .�.5: C-. ';7• • • f g��• •.• • • • , Name of Former Owners �`/. . .19C�•r�n!• 11. Zone or use district in which premises are situated .�!Y+. •r•► . . .1. •jiQI1'0 •�,1� ,!',� . ' ' ' ' _' 12. Does proposed construction violaXe any,zoning law, ordinance or regulation: . .IY'V.. . . ... . . . . . . ... . . . • 13. Will lot be regraded . . . . . . . • ,NO. . . . . . . . . . . Will excess fill be removed from premises: Yes Yes • • N • 14. Name of Owner of premises 1?®11!(J!�A...�' ,iz!�TS � d Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address n , •, ress . . . . . . • • • . Phone No. . rl --sue . . . . . . Phone No. Name of Contractor . Address . . . . . . • • .Phone No.. •t� 15. ' Is this property within 300 feet of a tidal wetland?� *Yes. . . . . . . . 1/ " ' • " " " " . No. . . . . . . . . *If yes,, Southold Town Trustees Permit may—be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether 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 interior or corner lot. APPmo.9tv D AS NOTED DATE: B.P.# FEE: 7 BY .r� NOTIFY BUILDING DE P ENT AT 765-1802 9 AM TO 4 FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATI0\i - TWO REQUIRED FOR POURED CONCRETE t ICH A H . 0 Ro�J� y Aj?"N IP.• tl .��t`��, Aust t,Y Wi,},l i ten(' s, tim�; F . SHALL MEET OF T+-IE Ky s� C0% i � F'[ t..'<N'=i 1CTIO�ni Po . ENIFI Gv n r� RI NIPF F?r ::'�ti U ;, l CONSTRUCTION ERROR,:, C y STATE OF-NEW YORK, S.S COUNTY OF . . . . . . . . . . . . .. . . . • • Q.N.f1.��?. . .f,•.. . . i T SC, being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . :,. .� L2<f+(k PT!-. QJ�S.T�6. . ..��d?ti�1. �J. .fi� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent; corporate officer, etc.) 3f 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 STANLEYSLEDJESKI p Notary Public,State of New York . . . . . . . . . . . . . . . . .day of.,. . . . . . . . . . . . . ., 19,7� No.9041175 Suffolk County t. My Commission Expires 9/30/19 votary Public, . . . . . County . :•���t"y •��.. . . . . . . . . . . . . • • (Signature of applicant) - ITr.v:ti*+ - im""„ •-- I "r ��rdJ S I.�rY4rtil j�,'S'J - r....,.•..sa •s i i'n i J 1 1 T�"-49fr✓ ^t, yt'',,:>' t 1� 7 rV4, X r J}C'Jr'f 4 c r t 1 ti � 2: Ap hh y� 7 V\`�•4 `S kN L 4fk4 p ll l l I' I � �•'� 7 ;• { 1 e -.j � " h•�5, kg 4ri� ��n��Fq��''tr ifnl� e K9 i _ '`gam � ,,�'�, � �4 ?:: •.� �� . ® qp a c 01 k A AL ' �' •", '� ° � awn . ID _ l • .10 A. 0 CO • �. o �` QEE Il.i• 1 1 It'fI rtl u•I.h•li,•r+ r,t 003.1•0,1 10 Iln, in t i.aCua`n ',I9 t+f III• {•.•r 1Jf1 §ly{r L<%uCuhpll ltn: {� �a ) • �.��.•`' 7 Iwl tl't..e I Illd }rOq/IM� I^.a Itll rt: N/t vt y'IA+t.•••lrr{ A il&D�rs °ru t ..a. c- r.�F.) S, � i 1���I v" ?n Jt .+t ,.Lr.•r�l t ., 1T{� ptL �.^ �hhaL{i•.•l� Sd {•t r .��+I`tnP+ �j,�e� ���I, �.` • • _ r'.II Vi. ir, ♦ V.1 . Ir.r,. .t. , lfr l•.td.•d 1.�1✓.'n :�btlt 1.•1) •'�' Id. :.1. tliC�O ���Y�+1�6f4/ 61•1-1 -•. u. ••IJ 1: rlr..{r.R::.t+vf ."I lu► I. �.�.'! L...Ilrq'' �.�• �rlti?iW, . d1{ 11.1ZA1 ''lily W !"1 ' t tl� +. I I. I u In.��Y t.. 11,•..!...�r •r:r.l.•.�t�.lr.lr•J �� fi 11'� •I� •• 1� f'i..t y.l- I IJ I, -.:i.Pf of :h, Id it1,: •i/dt'tl'f. t IC'diUli dr t S . . 1 J .. t•r.1: r 1 .:If1:.•...I�` 'r ., . •h•.1 .Ir.1rY'r11'�'I1f rr ,_ ++s:.—.s,:vvw-+—s ��ae••-•--•—•®ra,o ..rwn.:r...�....•._...H++-n..+..we.n•n�.:av°.v. SURVEY FOR R�FLkEiVC� P1LCD, /14N.1$ 1949 MAP NO. 1679 Other 'Trode'x Licenp { _. one. Mcp No.` st✓..c.-�. ...............n... Loc on of land on which propelled �vv�,rk vtii9 be r� t , 0.{..(A M1••r!••• ����. StreeP.;'rind Nut-nber ,.... 2. State existir� use and ocyupon=y of prc--nice; and intended use and.pczlapnncy of proposed construct . .1.,C4 N,Y/..r .f".,ft; . .: ...........................•......,......:... o Exisiting wte and occuPaMy .. .. ... ; c.:.. ............. ......................r.......... intended . I I i t,CJkJ�1G �I /pi �.9 t�1p D 1 Y.�cIF1 C,t�S 1�?� I ® i I I I I � �� � I I I ! Ia- _I I ► - { 1 I I I - ! � � I TT- llUl f I { I ; 9 1994 �WSLDG�DEpT, OFSO OLD { I i 1 s s�,.; x .: ------�-------a.r�=_------- :%, �::,r. � _=i ;_