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HomeMy WebLinkAbout8025-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspectnr Town Hall $outhold, N.Y. Certificate Of Occupancy No...g 13 7.4.2 ........ Date ..... A.u. g9.s.~.. ~..2 .................. 198.5.. THIS CERTIFIES that the building ...D..eD.k..a..n.d..f..e..nD.e ........................... Location of Property al 3.0..T.b~r.e.s.a...Dy. & 2985 p.e.e.p..hp.l.e' ..DF... . M.attituck House No.' ........ Street .............. County Tax Map No. 1000 Section . . 1 .1 5 ....... Block .....1 .4 ......... Lot ....... 0.0.9. ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Pem~it heretofore fried in this office dated ..... 4ur~.e..26 ......... 19.7.5 pursuant to which Building Permit No. 8..0.2.5.Z. ............... dated ........ J.~a~. 2.6. ~ ........... 19.7.5., 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 ......... Deck and fenc.J_.na ...................... The certificate is issued to ....... JOHN PROIOS ( AXELSON .............. .................... of the aforesaid building. Suffolk County Department of Health Approval ........ .nf.a. .............. UNDERWRITERS CERTIFICATE NO .................. n / a Rev, 1/81 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZIED) N? 8025 Z Date ........................... ;]'.~JO.e..... 2.6. ......... , 19...~.~. Permission is hereby granted to: .... ~'~.e~L..AXe~L $.0~ ............................................... .................. ~a.~.t,~:.~ ....................................... Fo ....~JL&..a~..~d~,~,.~:L~a...( fi.~..c..~,)....a.~....~..e..r~9.~.n..g ................................................................. at premises located at ...... i~?.?..P..h...°..]:..e...?.~.J-...v....e.. ................................................................................. ................................................................ ~/~.tt ~tuCk....~.. J~ ~ ............................................................ pursuant to application dated ........................ ,]'.!J~e.....26. ............ , 19...~.~[., and approved by the Building Inspector. Fee $.:L-~,,©g ........... Building Inspector I~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be fitled in typewriter OR ink, and submitted ia II1~11~ to the Building Inspec* tor with the following; for new buildings or new use: 1. Finat survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--iS-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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all 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: t***1. Certificate of occupancy $5.00 **** 2. Certificate of occupancy on pre-existing dwelling $].5.00 3. Copy of certificate of occupancy $1,00 4.Vacant Land C.O. $5.00 .~./..~...~/..~..~.. Date ............ New Building X Old or Pre-existing Building Vacant Land 2130 Theresa Dr. Location of Property 2985 Deephole Dr. . Mattituck House No, Street Ham/et Owner or Owners of Property John Proios ( permit under - Axelson ) County/ax Map No. 1000 Section 115 Block 14 lot.. 009 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 8025Z Date of Permit 6/26/75 .Applicant Health Dept. Approval N/A .Labor Dept. Approval N/A g B App Underwriters Approval ....................... Plannin oard reval ...................... Request for Temporary Certificate ..................... Final Certificate .... X Fee Submitted $ ............................. Construction on above described building and~er~mit me. ets all applic?le codes and regulations, Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N~Y. 11971 TEL. 765-1802 July 17,1985 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /~/ An application for Certificate of Occupancy is not on file. ( enclosed, please sign ) /~/ ~e-~e~&-4~-o~&~e~e~. No Check, the fee is $5.00 /~/ NO final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. * building permit ~ 8025Z Filed under Axelson - for a deck addition and fence. Building Dept. Dorothy S. Mi~ley Building Dept/'~Sec. $. 83 °~O'~O"h-. BUlLMN4 WARTMINT I~ I~'~(c~¢ )~.C~ ~ AP~I~T~ IN~U~I~ ~. This a~lic~i~ mu~ ~ ~ple~ly fill~ in ~ ~ewriter or.in i~ a~ s~mi~ in triplico~ ~ ~ BulMi I~r, wi~ 3 ~ of p~, ~cu~ pl~ plan ~ ~le. F~ a~ng ~ Kh~ule. b. Plot plan shying I~ation of lot and of buildi~s ar~s, and givi~ a detail~ d~ription of c. ~ work ~er~ d. U~ appeal of ~is application, shall ~ k~t on the pmmi~ ~ilable ~r ins~ti~ e. No building ~all ~ ~cupi~ or u~ in whole or in ~ for any pu~e ~mever until a ~ifica~ of ~cu~ncy shall h~e ~en g~t~ ~ ~e Buildl~ In--tar. APPLI~TION IS HEREBY ~DE to the Buildi~ ~ment ~r Building Z~e O~inance of the T~ of ~hold, Suf~lk Count, New York, and ~her applic~le R~ulations, ~r the con~m~ion of buildi~s, ~itl~s or ol~mti~s, or ~r ~e ~ppllcent ogres to comply with all a~licable la~, ordina~, bulldl~ c~, h~ln admit out~riz~ in~o~ ~ premiss ~ in buiMl~ ~r ~e~ff i~ti~. ~a~ ..... ......... ....................................... (Add,ss of ~plicont) State whether applicant is ~ner, les~e, agent, amhit~t, engineer, general c~tmctor, electrician, plumber or builder.~ ................................... .................................................................................................................................. ~ner Name of of premiss ........ if applicant is a corporate, 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 ............................................... . Q.//~'~,~,~.,,~, ff Location of land on which.--r~__ --~ ~pr°p°sed work,,~ill~e done. Map No.: ~1:{~..~..z....~...£ ...... Lot No ......................... Street and Number ........ ...J~...~....~......~.~.~......../-'~..~.../....e/~....~..x~...~...~.../.-.~..~ ................ ~ .......................... Munlcipali~/ State existing use and occupancy of premi~ee~and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .......... ~..~...~ ................................................................................ .. ................ I 3. Nature of work (check which applicable): .New Building.. ................. Addition ...~.. ...... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................. ~ ....... ~;..... .... /~ --- ~.._ (Description) 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 some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10~. Dote of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. V~ill lot be regroded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Nome of Owner of premises .................................................... Address ................................ Nome 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 N~, ~ ~: c .................... ~~.rr..~F. ......... ..'w~..being duly sworn, depots ,',nd soys that he is the opplican~ (Na//m~of incfividual signing contracO above named, t' He is the .................................................. ~ .................................. i .......................................................... (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 knojFledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. // . Sw?.m to before me this ~ .~. -- //