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HomeMy WebLinkAbout8015-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23951 Date OCTOBER 16, 1995 THIS CERTIFIES that the building Location of Propert~ 450 MAPLE AVENUE House No. County Tax Map Ne. 1000 Section 107 Subdivision ACCESSORY MATTITUCK, N-Y- Block 3 Filed Map No. Street Hamlet Lot 4 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 24, 1975 pursuant to which Building Permit No. 8015-Z dated JUNE 24, 1975 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 INGROU-ND EWII~4ING pOOL & FENCE ENCLOSURE. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED EDWARD & STELLA McLAUGHLIN N/A H-045789 - JUNE 8, 1995 N/A Rev. 1/81 FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION 'OF THE WORK AUTHORIZED) N°. 8015 Z Permission is hereby granted to: ...~;.~Lc~..&..~zx~-~...~e.~.o ............................... ........ .~.~..o......~t~t~¢...t,~m~ .......... tfa.t.t4,.~.ucl~ .... to ...h~r~...-~.,~ e~ ..,~,,,~,~,~hr~.. .......................................... at premises located at ..)4-.~'/~ ....... ~.~p.],O...~O ........(.O~./:..G~d,..A.~e...) ..................................... ................................................................. ~a.tti.~uek.....~.~.. ........................................................... pursuant to application dated ......................... J.~'*j~e. ........ .2...~. ......... , 19.~..~.~..., and approved by the BuiJding Inspector. Fee $..'.l.~.?...r~. ........... Building In~peTr THE NEW YORK BOARD OF: FIRE UNDERWRITERS 8G54G90 BUREAU OF ELECtRiCITY, ~v BE JOHN STREET NEW YORK~NEW ~ORK 1OO3B Date JUN~ ~ ~ .1~5 Application No. on file ~7~995/95 THIS CERTIFIES THAT O~y the e~trtcal eqaipment ~ ~scrlbed be~w and int~uced by t~ applicant ~eE on the a~ve application number in the premises of EDWAI~D ~d~k~UG~LIN~ ~5~ M~PL~ L~E~ MATTITUCK~ N~Y. in the following location; ~ Basement ~ Ist FI. ~ 2nd ~7. 0~ ~ Secth, n Bilk Lot andfJund4o b~in compliance with the NaHonal Elect~cal Code OUTLETsFIXTURE RECEPTACLES SWITCHES FIXTURES RANGES C~KI~GDECKS OVENS DISH WASHERS EXHAUST FANS SERVI~ DI~ONNECT ~' S E R V I ~C E ~NO VIc, UKL ~EFEC'~'8~ "An elect.[~[cal survey has been made of the electric~%l equip ant~ J]n~h~ ................... .~; ~ r~ premises indJ~cated." "~o obvious unsat~sfactoly conditlo~ was found. YORK ~A~ OF fl~ UHHRWm~ FR~NKLYN SQ. , ~Y, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST 1- ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS'/~F"( ~ ~,/~ ,~~/"~"-'-- DATE ~/~--/~' _,NSPECTOI THE NEW YORK BOARD OF FIRE UNDERWRITERS nr BUREAU OE ELECTRICITY YORK, NEW YORK lOOS8 Carlos TeJo~ Maple B~e~ Or~d Ave. & End, MattStuck,.L.I;' was examlned on March 10, 1975 andyoundtobe~nco,,,pllancewiththereqalrementsofthlsBoaed. DRYERS FURNACE MOTORS FEEDERS TIME CLOCKS MULTI-OUTLeT SYSTEMS NO. OF FEET iL ~o S R E OF CC, COND. C NO. OE HI-LEG A. W.G. NO' OF NEUJRAL~ OF HI-LEG (Swimming Pool) This ce~cificate covers inspection only. Because of unusual environments it is advisable to have frequent test and/or repairs made by a qualified person. compliance at the~ of Glenn ~. Bradley Horton Ave. Mattituck, L.I. 11952 D This cerfif~cote mu~t not 5e ~ltere~ in any mcmner; return to the office of the i~oGrd if [ncqrred. Inspectors moy be [dentified by their OF NEUTRAL FIELD ][NSPECTI]ON REPORT DA_T~_ ~_ ~ COIql~NTS ~NS~T~ON PER N. Y. STATE E~R~ CODE FINAL ~D~TIONAL CO~S Form No. 6 TOWN OF SOUTHO[,D BUILDING DEPARTMENT TOWN HALL 765-I802 APPLICATION PeR CERTIFICATg 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: [. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Pinai Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. d. 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. 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 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 ttle applicant. C, Fees t 1. Certificate of Occupancy - New duelling $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-existin~ Buildine - $I00.00 3. Copy of Certificate of Occupancy - $20.00 A. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $I5.00., Commercial $15.00 / ......... .................. New Construction. F ......... Old Or Pre-existing Building ................. r ~ocatio~ of Property..~..~...,~. ~-~. . . ':4'-'~ ~' " ~' '~~'~ ..... :"/: ...... Itouse No. / t Street Hamlet / ' ~o~, T~ ~ ~o ~o0o, ~on.Z~.7 ...... B,~,~,~ .... a ......... ~o~...r..~ ............. ~ubdivision .................................... F()~d biap ............ Lot ...................... HealLh Dept. Approval .......................... Underwriters Approval ......................... 'ianning Board Approvrll ........................ '~equest for: Temporary Certificate ........... Final Certicate ........... Tee Submitted: $.c~.~.b ~ ................. ,~ Co ~39~; Approved .... ~ ....... ~'. .......... '. ........ , TO~N O~ $OUTSOLD BUILDING DEPARTMENT TOIA'N CLERK'S OFFICE ~UTHOLD, N. Y. Perm,t No....~...~..~.~ ..... Application No ................................. Disapproved a/c ...,.~ ............................................................................ ~ ............................. ...... .. · .................... ................................ ~ ~(Building Inspecpr) APPLICATION FOR BUILDING PERMIT /~ ...... ....... ..... INSTRUCTIONS ua~e ~... ., 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 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 w[ll issue o 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. ( 'g pp · , , · p - ...... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. Name of owner of premises .............. .~......~....~.,.O...~.. ....... '~'~....~..'.O.....,.....~.:....~.: ...................................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's License No ...... ..~.~...~.....t/..~..........~Z,~ Plumber's License No ................................................. Electrician's License No ............................................. No. Other Trade's License .............................................. ' · ' Lot No Locohon of land on which proposed work will be done Map Streel and Number ...'.......~..~..~...~.~ ...... /~.-./~. -~. .......... i ...... ~i~~i~i~_".~.'.'.i ............ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....... ~~..-"' ..~..q..~....~'.. ........................................................... b. Intended use and occupancy ...... ~~'~'.~)..~...~. ~:...~*. / 3. Nature of work (check which applicable): New Building,. ................. Addition ........ .../~....... Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work .................................................... 4. Estimated Cost .... , ....... !'.. .:.....~.. ................. 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 ............................................................................................................................................. 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. Dimensioas of entire new construction: Front ............ J ...... , ................ ,~tl IO! Rear ............................ Depth ........................ Height Number of Stories ............................ · .~ff?....~. ................................................................................ 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 regulation: ........................................................ 13. Will lot be regraded' . ........................... Will excess fill be removed from premises: ( ) Yes ( ) No p em~ses ........... .~. ...................... ~.....~?..'J)... Address .......................... 14. Name of Owner of r ' C ~',~.. '7-~'q'~ ....~..~.~.7-/7'~,/c~. Phone No. ..&.~...~.:..q.:?.?..~ Name of Architect .............................................................. Address ................................ Phone No ....................... Nome 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 corner lot. STATE OF NEW(T'~)R~,/ ,if, lcS COUNTY OF .~J~a~6~g.¢~-~C......~2~''~ ...................... '.i~-~ .......... /.~_(;~/,~1~ ...................... being duly sworn, deposes and says that he is the applicam (Name/of individual signing cJ~tracf) above named. .,,~le 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 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. Swo~,,~ I ~rC-/xt° befJore me this ( 1 ~9 · ,~ ~ ~ ~ II,~'~ ' ,~ ,~ /~ (Signature of~?plicont) NOTARY PUBtlC, State ol I~en York i%. 52-8[25850, Suffolk ~ourttvj~_. Term Expires March 30.