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Home My WebLink About5529-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28020 Date: 10/19/01 THIS CERTIFIES that the building ADDITION Location of Property: 685 SIGSBEE RD L~UREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 143 Block 2 Lot 13 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 27, 1971 pursuant to which Building Perm/t No. 5529-Z dated SEPTEMBER 27, 1971 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 EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to FRANK C. & NANCY A. TODRICK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~rmu N/A N/A N/A ~u/or [~natur e Rev. 1/81 NO. :~ TO%VN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CFHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5529 Z Permission is hereby granted to: . .............. ................. .................... ~!~tt~a~ik ............ : ........................ to ......... .**k~.~...~...~ **~.~...~...~.~.~! .-. s ..~ ~.. ~,~a~a...C .~...~.~ ) at premises Ioccrted at .......... ~IK~..I~. ................ ~t,~1~..~.#/i~1~..~¢~11. ...................................... ....................................... m4e~..~ ......... .~t~tu~ ................... . ........................................... pursuant to application dated .............................. ~.~. .......~. ........ , 19.~..~.., and approved by the Building Inspector. Building Inspector FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PEPa~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 5529 Z Date SEPTEMBER 27, 1971 Permission is hereby granted to: FR3LNK JR & NANCY TODRICK MATTITUCK,NY 11952 for : BUILD ADDITION ON EXISTING ACCESSORY GARAGE AS APPLIED FOR. at premises located at 685 SIGSBEE RD LAUREL County Tax Map No. 473889 Section 143 Block 0002 Lot No. 013 pursuant to application dated SEPTEMBER 27, 1971 and approved by the Building Inspector. Fee $ 0.00 Authorized Signature ORIGINAL FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...~.~'.~.;:,.~...(.~...i~. ........ , 19,.~:..{. Application No...~..~;..t ............. Approved ........................................ , 19....~... Pemit No...~....~..~..~...~ ........ Disapproved a/c ........ ~:,~...._ ~.~~: ...................... AFPLICATION FOR BUILDING PE~IT D*te ........... ~,.~...~. ........ , 19>.~ ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 ofproperty 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 progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy s. hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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, ~b~, ing code, housing code, and regulations. ......... ....... .................. /(Signature of aRplicant~ or name, if a corporation) ..... ~+~. ............... ~...~, .......... ~.,'-_.-..¥....~ .............. ~/ ~ (Address of applicant) State whether applicant Js owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~-~i 1. Location of land on which proposed work will be done. ~nop r~o.: .~:.~.(.~;~.L.~; ................... L~t No.' ........................ Street and Number ........... ~..~..~ ...... r~.~ ............. ~,.~,~.r..~. ................................................ ~ ~ ~ ~ ~nici~li~ 2. Store existing use end ~cup~y of premi~ond infended pse end ~cu~ncy of p~sed c~structi~: ...... ............ ........................ ........................................................ b. Intended use end ~cu~y ...................... .~. .................................................................................... 3. Nature of work (check which applicable): New Building ' Addition.........J... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .......................................................... i~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 ............................................................ t ..................................................... ~[; ........................ 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 Stones .................................................................................................................... 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 regul_ation?~.~ ..y~ .................. ; ...................................... 13. Name of Owner of premises · .~.,~..~../..~....~,.~.'~..:.../C....Address~ ~.~.. . ~'. ~:........ ~.,;L~ ..................... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ............ -~ .................. ,.Address ............................................ Phone No ..................... 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 comer lot. .... ~ ~ ~,_ STATE OF N E~ Y.~e. JC_ t~ ~ cou NTY~O~..'......,,.... J -L:. , (Name of individual signing~;LDplication)/~)~ .~ . . ~ ~ [/.~ /., above named. He is the .................~..:,.~[..~..~ .................................................................................. (Contractor, agent, corporate offJce~, etc.) of 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 contctined Jn this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the applig~tion filed therewith. Swam to before me this / ,. .............. ...... ...... , :. Notary Pub'-/') '-~ ... Coun~-,~ (Signature of applicant) ~' ELIZABETH ANN NEVILL~ ~/ "'~' NOTARY PUBLIC, State of New York No. 52.8125850, Suffolk Cou,~ T~rm Fx0ire~ Mar~h 3(I. lg BLDGi DEPT. '~'N OF SOU~OLO Form No. 6 ('i~,~bL~CdS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FORCERTIFICATE OF OCCUPANCY 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 Comptianee from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application a~d 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ .25~D 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ... ~ .~..] .~.-7..~. ( ........................ . New Construction ........... Old Or Pre-existing Building ................. Pro crt ~..~.~ .~.~i- %~. ~.~t.~. ,~.j .TT.~.~ Location of p y ' House No. Street Hamlet Onwer or Owners of Property . ~. ..... ;... ,.l.C~.~ ................ lq.3. County Tax Map No 1000, Section ......... Block ............. Lot .................. Subdivision .................................... Filed Map ............ Lot ...................... Permit No....~..~. ~..~.~...Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ / Request for: Temporary Certificate ........... Final Certicate .......... ~. Fee Submitted: $....2~i'.~.'.~i ................. H_~ ~ L ~~I ..~ 6k c. ............. ................. CO ~0~ 0 APPLICANT 98/17/2081 15:33 6~1727~144 YOUNG YOUNG PAGE Sur:~ey for' · FRANK 6 ROSE ~DRICK Mot! itu~k THIS SURVEY NOT TO SE USED FOR ~LE PURPOSES Seole, I, ,--