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Home My WebLink About7916-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22232 Date MARCH 30~ 1993 THIS CERTIFIES that the building ADDITION Location of Property 2705 MARRATOOKA ROAD MATTITUCK~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 2 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12r 1975 pursuant to which Building Permit No. 7916-Z dated MAY 12~ 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 ADDITION TO ~x[STING ONE FAMILY DWF3.LING The certificate is issued to P~WRY SEIFERT (owner) of the aforesaid buzlding. SU~'~'OLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS cERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A · · ~ilding Inspector Rev. 1/81 FOIg~ NO. :~ TOW'N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 7916 Z Permission is hereby granted to: g~r~.3r ..~e~l~er t.. ~.. ,/~w ....................... .......... I~o~c..~8~ ............. 3~ttt. t~mk ........... ~ o ...b~Li3xI.. al~ .~d~ ~t ;~n.. ~n...e ;~ ~t ;K~ g..(t~tt.i.n¢ ........................................................... at premises located at ]~'~;04~k&.-;~,.~l.~. ....................................................................................... ................................................................... ~at~it~ek ...................................................................... pursuant to appli_cation dated ................. J~......~ ..................... , 19.~.~.., and approved by the Building Inspector. Fee $.:~5..~ ........... Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Ao 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 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: 1. Accurate survey of property showing all property lines, streets, buildimg 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 the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Addztions 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 - ~5.00 over 5 years - $10.00 '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 ................. Location of Property .... ~ .................................. - . .......... ... House No. Street Hamlet Onwer or Owners of Property... ~.~/.-~7~. County Tax Map No 1000, Section.. /2 3 .Block. ~- .Lot Subdivision .................................... Filed Map ............ Lot ...................... Permit No...~..~. Z .Date Of Permit.07/.~& /..D~.~. ' --,~I ~','~ ............. Applzcant ...... ~.~.~ [ ................... f' ! Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ .~ ~. ?.~. ...................... ' ~ ' D sopprov ........................... ~' ~ ! ~' ............................ ctor) ~s~ ti ~ -z. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Th~s application must be completely filled in by typewnter or in ink and submitted in triplicate to the Buildir~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of Iot and of buddings on premises, relahonshlp to adjmning premises or public streets · areas, and giwng a detailed description of layout of property must be drawn on the d~agram which ~s part of this applicatio~ 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 perm shall be kept on the premises available for ~nspection throughout the work e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to tl~e Building Department for the issuance of a Building Permit pursuant to tJ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulahons, for the construction of buildings, additions or alterations, or for removal or demolitson, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. (S~gnature o~t, or name~/~f a corporation) ..... ........ .¢. ......................................... (Address of applicant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build.' .................................................... .O...~. e...z' ......................................................................................................... Name of owner of premises ..... .~...e..~..~..~.....~.e..'.z..~...e..~...~.....~...~>Z.~.~..e. ............................................................... If apphcant ~s a corporate, s~gnoture of duly authorized officer. \ (Name and title of corporate officer) Budder's License No ....... QI~1~.1~ .................................. Plumber's L~cense No .... ]~.^~.~f)j.],...~.8..t; ............... Electrician's L~cense No ...O~'zte~. ............................. Other Zrade's L~cense No ............................................... Location of land on which proposed work will be done. Map No · . .... ~ .................... Lot No .... .~....:~%.. ........ Street and Number ...~[8.Z'~.O.O~F;q,.~ ......... }:.~.~.~J..~.l~ ................................................................... ' I(0 ~J~ Municipality State ex~shng use and occupancy of premises and in'.ended use and occupancy of proposed construction' a Ex~sltmg use and occupancy ..... .q'k~'f~_'i.~L,1~ .................................................................................. b. Intended use and occupancy .............. .s..~...~..e....?11~ 3 Nature of work (check which applicable) New Budding .................. Addition ...... ~ ....... Alteration .... ~.~.... Repair ................. Removal .................. Demoht~or~ ............. Other Work ............................................... (Description) 4 Estimated Cost ................... .1...0..0...0.......+. ...................... Fee ..1.~......0...0. ...................................................................... (to be pa~d on filing this application) 5 If dwelling, number of dwelhng units ....... ode .............. Number of dwelhng units on each floor ......................... If garage, number of cars ................................................................................................................................. 6 If bus~ness, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7 Dimensions of exmtmg structures, ff any Front ...................... Rear ................................ Depth .................. Height ........................ Number of Stories ............................................................................................................. D~mens~ons of same structure with alterations or addmons' Front .................................... Rear ................... Depth ................................ Height ....................... Number of Stones .............................. 8 Dimensions of entire new construction: Front .......... .1.,~'..-.6 .............. Rear ........ .'[.~.-.~. .......... Depth ....~.~. .......... Height ................... Number of Stories .Q~.6: .................................................................................................. 9. S~ze of lot. Front ........................................................ Rear .......................................... Depth ............................... 10 Date of Purchase ...................................................... Name of Former Owner ....................................................... It ti 1 1. Zone or use district in which premises are situated .... ,~,.....d2.~.t. .......................................................................... 12 Does proposed construction woJote any zomng law, ordnance or regulation ........ .~...O ........................................... 13 Wdl lot be regraded ......... ..g.O. ............. Will excess fill be removed from premises: ( ) Yes ( ) No 14 l'~arne of Owner of premises .....~z~..y...~.'i f.e.z'.t ............... Address ....~a.t~ ................... Phone No ....................... Nome of Architect ....................................... Address ................................ Phone No ....................... Nome af Contractor ........... .o.t~..e.~. ......................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and red,cate all set-back dimensions from property hnes G~ve street and block number or description according to deed, and show street names and indicate whether interior or corner lot see attached plan STATE OF NEW~YQI~K . [ c c COUNTY OF . ~..~..[.Z.-..O3~... ........... .................... ..~....~..?..xT....~7....~r...'.:...'~..~-Z-.....~.../...~...~....~'.....z~.. ..... being duly sworn, deposes and soys that he ~s the apphcom (Name of ind~wdual s~gnmg contrac0 above named He ,s the .......................... .0...'~.~.e...~. ........................................................................................................................... (Contractor, agent, corporate officer, otc ) of sa,d owner or owners, and ,s duly author,zed to perform or have performed the sa,d work and to make and fdc this application; that all statements contained in th,s applicahon are true to the best of his knowledge and belief, an, that the work will be performed in the manner set forth in the opphcat,on filed therew,th Sworn to before me th,s ..................... · 1..2day of .......... ~. ............... .}'..~..~r. ...... , 19. 7~. ~~~ (Signature of o~plicont) NOTARY PJflBL~C, S~e o[ ~'ew York No. B2-4~2202b - Suf;oJ',, Commission F. xplres tAarch 30,