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Home My WebLink About6871-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17130 Date JULY 28r 1988 THIS CERTIFIES that the building. Location of Property. 505 House No. Street County Tax Map No. 1000 Section 99 Block 1 Subdivision CAPT. KIDD ESTATES Filed Map No. 1672 ACCESSORY SOUND BEACH DRIVE MATTITUCK Hamlet Lot 22 Lot No. 18 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 18¢ 1973 pursuant to which Building Permit No. 6871Z dated SEPTEMBER 18~ 1973 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 BUILDING. The certificate is issued to NICHOLAS & CHRISTINE LEIMONE (owner, XXX~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLLrMBERS CERTIFICATION DATED Rev. 1/81 FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDI~4G PERA~iT (THIS PERMIT MUST BE KEPT ON THE P,REMISES UNTIL FULL COJ~APLETION OF THE WORK AUTHORIZED) N? 6871 Z Permission is hereby granted to: ..... Ihozp../~o~e ........................................ 8ou~ Beach Road ................... ~V~.t~ltue~, .................................... ~o ~.~.....~....a.~.e.~.~....~.,...t..e....~..~..).....b..~.a.....~. ............................................................... at premises located at ..LO~..~. .............. (~)~..]~k~(~,..]~J~.dl, t. dl.~ ...................................................... ................................. ..s..o...,~......~..e..a. ~..h....~..a..a.. ............. ~.t...t..$.~....,~.:? ...................................... pursuant to application dated ...................... ..~..$.p..t......~..8. .............. , 19.~..~...., and approved by the Building Inspector. Fee $....~J~.&(~. ........ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPAI Instructions This application must be filled in typewriter OR ink, and submitted ~~ to the Building Inspec- tor with the following; for new buddings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building, 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing ali property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3.Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees:' Additions $25.00 POOLS $25.00 ALTERATION $25.00 1~__~_~~,~ New Dwelling $25.00, Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of cert~ficate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ... .~. NewCons truc %ion ...... Old or Pre-existing Building ............ Vacant Land ............. House No. Street ~ . I~amlet Owner or Owners of Property ....... &~]t" ~'~g ./.~.3. .... .~..~.~.~ .,-~//.~.~ ..... .~..~.~,~2¢).~.~'~... County Tax Map No. 10O,~tion..~, .~'...~:.¢..~/... Block ...../~'..~. ?. ...... Lot. ,~....~...~... ................ z ..... Permit No..~.(.~.:~./.. Date of Permit..~//~ .Applicant ~.~., d~ · ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... ~equest for Temporary Certificate ......... :~ ........... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and ,p/e~mit/m~ts all~phcable codes and regulations. C'O'~:=~'-"[~";~O App cant .... ~/.~,.~../.~/,/~. ~. ~%/./~..'.~..z~..".' .i'.-. ................. Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 This is to advise you that the job under building permit no. ~%~I~ issued to ~Cq~ ~iMo~ on ~l\Mlq~ for Q~ Ctless~mcq ~c~qe. bcdd,~q is completed and a final 'inspection has ( )t has n3t ( v/')~been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for ~O~-~--'- %payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly yours, Victor Lessard Executive Administrator VL: 6~ encl. Examined ~ t . .~.~ Approved ........................................ , FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ........ Pemit No ..................................... Application No ................................. Disapproved a/c ............................................................ / .............................. ........................... b APPLICATION FOR BUILDING PERMIT Date ......................................... , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, witt~- 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, ana~ giving a detailed description of layout of property must be drawn on 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 or~ the premises available for inspection throughout the work. 1 e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have bee~4~l 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, Suffotk 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 ali applicable laws?,, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on p r ~r~ and in buildings for necessary inspections.~ (Signature of applicm~t, or narn~, if a corporation) State whether applicant is owner, leLs~e, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................................................................... if applicant is a corporate· signature of duly authorized officer. Builder's License No .............................................................. Plumber's License No · · ........................................................ / Electrician s License No ..................................................... O her Trade s L~cense No ........................................... .~ ....... 1. Location of land on whi~rroposeclp, wol~;;~ll be cJone, r~p ~No ........... ~ ......... .,,/..~../....,.~bt No.~.,.~.~,......~,~ ...... Street and Number ~'...'..~....~......~.....~.~'.~..~....~........~....~...~..~.....~.. ...... ~..~....~...~....~..CJ. ........ ~.~ ...... Municipality 2, State existing use and occupancy of prej~ses and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~..~..~ ..................... ,_. ........... ~.. .................. ~.~. ............ b. Intended use and occupancy ................ ~,~..~ ...~/~...x~....~ ................. ~.....; ........ · . -Nature of work {check which applicable): New Building ...... ..~. ............. Addition ..................... AIteration...=.....~.~., Repair ......................... Removal ......................... Demolition ........................ Other Work .~ ........ (De~lption) 4. Estimated Cost ........... : ................................... Fee ....~....U.....~...... .................................................. , .......................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~. ........ Number ~f dwelling units on each floor ......................................... If garage number of cars .......... 6. If business, commercial or mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ................. : ......... Depth ................................... Height ..................................... ' ...................... Number of Stories ............................................................................. Dimenaens of Same structure with alterations or additions: Front .......................... Rear ......................................... D, epth ................................ .: ............ Height ......................................... Number of Stories ........................................ Dimensions of ehtire new construction: Front ......................... Rear ............................ Depth ................................. Heigh:~ ................................................. Number of Stories ......................................................................................... Size bf lot: Front ............... ~ ...................... Rear .......................................... Depth .................................................. ' .Date of Purchase ..... .' ............................... Name of Former Owner ............................................................................ 11. Zone or use district' in which premises are situated ........... ~..~ ........ t,~, ,...,~ ................................................................ 12.' Does proposed construction violate any zoning law, ordinance or regulation: ...... .~ .~....~.: ........................................... 13. Will lot be re~rad~, d ............... J~l~_ ...... : ........ W~cessfill be removed from premises: [ ] Yes [ ] NO 14. Name of Owner of premises ~......,l. ...... (Phone No.) Name of Architect..~.~.~. .............. ~. ....................... .~. .................................................................................................. (Address) (Phone No.) Name of ContraCtor ../.~...?-....~'~.~'~.....~..~..~. ............ (Address) (Phone No.) -- PLOT DIAGRAM Locate clearly and d~st~nctly all budd.ngs, ~hethe~r ex~st~ng or proposed, and indicate all sat-back dim.e, nsions from property]ines. Give street and block numl~? gj~ d~rip~ru;~n,eccc~ding t~,e~de a~d show street names and indicate wheth- er ifiterior or corner lot. ---, ,,,~t~,~,,~ ~ ,,?.~. ,---~, -- .......................................................................................................... be'lng duly sworn, deposes and says that he is the applicant above named. (Name of ind~viduat signing contract) He is the (Contractor, agent, corporate officer, 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 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. Notary Pu ~....~,~......~ County ...................... ~.~......~..~L.~.~ ........ ; ...... { Signature 'o f ~tpplicant