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Home My WebLink About29373-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29441 Date: 05/16/03 THIS CERTIFIES that the building ADDITION Location of Property: 1575 COX NECK RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 7 Lot 19.19 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12, 2003 pursuant to which Building Permit No. 29373-Z dated MAY 12, 2003 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THEODORE R WELLS JR & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 440069 07/02/79 PLUMBERS CERTIFICATION DATED N/A or' ed S' nature 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) PERMIT NO. 29373 Z Date MAY 12 , 2003 Permission is hereby granted to: THEODORE R JR & WF WELLS 1575 COX NECK RD MATTITUCK,NY 11952 for BUILD AN ADDITION TO EXISTING DWELLING. REPLACES BP 8433Z at premises located at 1575 COX NECK RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0007 Lot No. 019 . 019 pursuant to application dated MAY 12 , 2003 and approved by the Building Inspector to expire on NOVEMBER 12 , 2004 . Fee $ 150 . 00 C Authori d Signatifre ORIGINAL Rev. 5/8/02 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 8433 Z Date ..............................Xar.........aa..., 19..76. Permission is hereby granted to: Tei..wltos.......................................................... .....................Aox..Xeak•aul..........iiattituak ................................................................................ to .......�1A...qLA-4.441U.94...QA.xU,1UAa..dwellum......................................................... ................................................................................................................................................................ at premises located at .......W/i6..Cv.Qx-Rack-RQ8d............................................................................ ..............................................................A&tt1 tuok............................................................................. ................................................................................................................................................................. pursuant to application dated ..........................Xa..r.....12............. 19...,76, and approved by the Building Inspector. Fee $...1.5..49......... ......... ...... ........ J`... .............. Building Inspector TWE NEWT YORK BOARD OF FIRE VNUEAWA,1Rnr R$ 4fSUAEAU OF ELECTAI01TY 5 " •y "8JONN..STREET; NEW YORK, NEW *ORK IC038 ". Date Jfx•ly 2, .19 79 dppiirotion No.on file 018180 N "1;S C,ERTIF,jE$ TkAT 4400,69 only:Xhe eleetrlcoequip"taht as desorBod below and introduced by the applicant named on the above application number in the premises of Ted Wells , Pox Neck Rd. , Westphalia & Meday St. , Mattituck, N.Y. in the foiloteing location,; ❑ Basornent 1�j ]stFf. ❑ 2nd Fl. Section Black Lot _ was examinedon Ju1le 28s 1979 and found to be in compliance with the requirements of this Board. LUET6 EC&TACLES 11 SVFiTCHES N URES a RANGES COOXIN DECKS OVENS.. IRS 4VA3f1 R5 VXHAUS F NS INCANUESCENT FLUORESCENT "VAPOR AMT _ K W AMt K W AMT. KW. AMT. K,W. AMT. H.P. 4 6 2; 4 DRYERS FURNACE:MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT TIME CLOCKS . .BELL UNIT HEATERS MULii-OYMS STRUTLET DIMMERS s AMT: kW 01l HP GAS H.P. AMi, NO. A.W.G. AMT. AMP AMT.. AMPS TRA S. AMi ; H.P NM Of FE AMT' WATTS" 1 600 4ERP1NLkT N6.iQF §•. E R V is t E AMT AMP TYPE QUIP 1-9 2W i g'JW ]g]W"3 g dW NO.OF CC ONO: A W O N OF HI-LFG A.W.G %J UG. PER g pF CC DNa. O OF NI-LEG NO OF NEUTRAL$ a JUG.kl L Ot"ek APPARAYU4: Ted Wells Rte. 1, Box 191A, Cox Neck Rd. Mattituck, N.Y. 11952 GENERAL MANAG Per_ 11 This Certlficgte must not be g1tered in any manner; return to the officeof the Board if incorrect. Inspectors may be identifiedby their creden 1g s.,'" Form No.6 -- TOWN OF SOUTHOLD BUILDING DEPARTMENT fflo�(A ld I-0 TOWN HALL Cl &4 C�,s v Ci�^er K 765-1802 �r / ?Rn? C.a�t zc42 J_.� PPLICATION FOR CERTIFICATE OF OCCUPAN�Y This application must be filled in by typewriter or ink and submitted to the Building Department with the following. A. 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 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 $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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Building: (check one) i Location of Property: _ /$�5 ^ 47lGlc r House No. Street Hamlet Owner or Owners of Property: T.ed the( I S Suffolk County Tax Map No 1000, Section7j Block 7 Lot q . Subdivision Filed Map. Lot: Permit No. d1'313 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $� Applicant Signature r937�3 �- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE l� INSPECTOR FORM NO. Y TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. Application No. . ..... .............. Examined ....... ... .. Gc!. .............. ., PP if Approved .............................. �.. 19!.Y... Permit No. .... .3.3.. -:...... Disapproveda/c ........... ...... ................... ............. ............................................................ .............. ............................... ......................................... (Buildin In tor) APPLICATION FOR BUILDING PERMIT Date ...........................ftr.......22., 19..76..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 application. 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 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 buildings for necessary inspections. Ted Wells .................................................................................................. (Signature of applicant, or name, if a corporation) ........... ................................................................. (Address of applicant) State whether applicant is owner, ,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................om ..................................................................................... ................................................... Nameof owner of premises ....To.d..WRQ.x.......................................................................................................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. .......9N9).................................. Plumber's License No. ................................................ Electrician's License No. ............................................ OtherTrade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: .........ZZ......................... Lot No. .XX.................. Street and Number ..W/..S..COX.Reek..Road..............Matti-tuck.................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .... V.4k .11M$........................................................................................................... b. Intended use and occupancy ...........p...............WIth..additim.................................................................... 3. Nature of work (check which applicable): New Building . Addition ...3=....... Alteration .---..— . Repair .................. Removal .................. Demo|ition......... .......... Other Work ................................................ (Description) 4. Estimated Cost ............................................................Fee ......15�00........................................................................ - (to be paid on filing this application) 5. If dwelling, number of dwelling units .......CM.............Number ofdwelling units on each floor ............................ |fgarage, number ofcars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions ofexisting structures, ifany: Front ............................ Rear ................................ Depth .................... Height ........................ Number ofStories --...----.--------__---,-..-.---------_--.----__--_ Dimensions ofsome structure with alterations or additions: Front .................................... Rear —.-------- Deoth ................................ Haight ............................Number of Stories ................................ 0. Dimensions ofentire new construction: Front --.--16—._----.-- Reor --_-16-_-..-' Deoth --1.6—.---. Height .................... Number of Stories ......OW......................................................................................................... 9. Size of lot: Front ........................................................ Reor .......................................... Depth ................................ � lO. Date of Purchase ........................................................Name of Former Owner ...... ll. Zone or use district in which premises ons situated ..........MA-111-dist..................... 12. Does proposed construction violate any zoning low, ordinance or regulation: ----0W.......................................... 13. Will lot be regraded ............)29.......... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name ofOwner ofpremises ........Ted.. ...................... Address ......NattItuck... Phmme No. .,.,.......,..,.-... Nome of Architect .............................................................. Address ................................ Phone Nm' ...................... Name of Contractor -----..own*.r..-----'—''--- Addrmss ................................ Phone No. ...................... PLOT D|AJSFU\M Locate clearly and distinctly all buildings, whmtheri and indicate all set-back dimensions fromproperty |i Give street and block number orc�h��i. ��deed and show street names and indicate whether interior orcorner lot. � ` | - � � 1 ' ^vt . ' �~ ~ STATE OFNEW YORK ( ' SS COUNTY OF ..-- ��.��8� al��---f ' ..............................Tad..J�e-1,14.............................................being duly sworn, deposes and says that he isthe applicant (Name of individual signing controcf) above named. He is the ...................................�lMer-bitUdex..--.—..------.----.--_-_--_--_------------------ (Contractor, agent, corporate officer, etc.) of said owner orowners, 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 thozthe work will be performed in the manner set forth in the application filed therewith. Sworn tobefore me this ---.----22'' day of .........................Harch....... l9....76 Notary Public, ...................ftfft3k............... County tn�...../'��---'�� -.----..--'^,-.^__.---..—........ ' (Signature of applicant) -f ?� yr v° � I