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Home My WebLink About9445-zFORM NO · 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34844 Rte: 02/25/11 THIS CERTIFIES that the building ACCESSORY Location of Property: 1020 NEW SUFFOLK AVENUE (HOUSE NO.) County Tax ~4ap No. 473889 Section 114 Subdivision MATTITUCK (STREET) (HAMLET) Block 12 Lot 16.1 Filed Map No. __ Lot No. conforms substantially to the Application for Building PermLt heretofore filed in this office dated SEPTEMBER 8, 1977 pursuant to which Building Pe~it No. 9445-Z dated SEPTEMBER 8, 1977 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 GARAGE WITH ATTACHED STORAGE AS APPLIED FOR. THIS CERTIFICATE OF OCCUPANCY REPL~%CES C/O Z-9442, ISSUED 2/16/79. The certificate is issued to GARY H ROSE of the aforesaid building. ( OWNER ) SuFfOLK COD1T~Y DEPARTMENT OF HEALTH APPRO~L~J~ Z.~CT~ICAL u~KTIFICAT~ NO. PLI~BERS C~TIFICATION DA'r~u N/A N 367306 12/07/77 +/u t h/i z e d'~'~iigna t u r e Rev. 1/81 TOWN ~ SOU~I~D BULLDOG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CC~PLL=T'ION Of: THE WORK ^UTHORIZED) N? 9445 Z Building Inwuector. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey °f Property with accurate location of all buildings, property hnes, streets, and unusual natural or topographic features. ' 2. Final Appr°val from Health Dept. of water supply and sewerage.dispusal (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 Pl.anning Board Approval of completed site plan requirements. B; Fo~ existing buildings (prior to April 9, 1957) non_eanforming useS, or buildings and .pre_existing,, land uses: 1. Accurate survey 0f pr0perty showing all property lines, streets, building and unusual natural or topographic features. : 2. A properly completed application and consent to inspect signed by the applicafit. Ifa 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 dwelliug $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $I00.00 3. Copy of Certificate of Occupancy - $.25 · 4. Updated Certificate of Occupancy - $50.00 ' 5. Temporary Cer!ificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Location of property: oep. a:9 A.~'~c-9~/__.F~_. ~c/~ House No. Street O, rorOwne 0fProperty: · 8u. ffolk County Tax.Map No 1000, Section/' I ~ q Subdiyision No.' C~ q (/~/ . Date of Permit. H~alth Dept. Approval: Planning Board Approval: Date. ~ (check one) :Hamlet Block Filed Map. Applicant: Underwriters Approval: Lot: Request for: Temporary Cetlificate Fee Submitted: $ _ Final Certificate: (check one) TOWN OF $OUTHOLD BU~.OING DEPARTMRNT Town Clerk's Of[ice Southold, lq. Y. Certificate Of Occupancy No. Z9/~/~2 Date February 16 19 79 THIS CERTIFIES that the building located at . .!0..~.0. .~.~¥..S.u..f.f.o.l.k...A.v.e... Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore ~ed in thi.~ office dated . .S.e.vt.t..e.m.b.e.r....8. ...... , 19..7.7. pursuant to which Building Permit No, .9..~. ~.Z.. dated . $.e.~.t~.b.e.r....8. ....... , 19...~ was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certdflcate is issued is ......... AccesaorF. Bull~ln~ ......................................... The certificate is issued to ......... Gary. l~.c~Be .................................... ( owner, ~ of the a~orezaid building. Suffolk County Department o! Health Approval .......... .~./.I~. ...................... UI~DERWRITERS CERTIFICATE No N'~67~/ - ~67~0~ ~ous~. mn~ER ...!.o?.o. ...... S~reet ......... ~.~...S.u..~.~.~...A.v.e. .............. l~t~tuck, New Building ln~l~eto, County Tax Number 1000-11~-12-10 * 16 FOUM NO. S TOWlq OF SOUTHOLD Building Department Town Clerks Office Southold, Iq, Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings 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 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 installations, 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 property 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 .~.~..j..~../.~. New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ...~,-..S.;......~...~.9~......-~..~.~.~,.Lc~../~X..~. ....... ~..~,...~.:.~...~...'~....(~.,..~... ....... Owner Or Owners Of Property ......~:.~.....~.....~....o..~....~.. ............................................................................ Subdivision ................................................. ..~...~ ....... Lot No ............. Block No ............. House No ............. Permit ,o....,.. .......... Of Perm t ..~.~.sc./..~.~...Applicant .~...,....,.'..~.....,z~.~ .............. ' ........................ Heolth Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board ,a~proval ........................................ Request For Temporary Certificate ........................................ Pinal Certificate ~ Fee Submitted $ ....~...;.' .~. .................... ................ day of ............................................ Notary Public .................................... County Construction on above described building an..d p~rmit meets all applicable codes and regulations. p,ican, ................................... Sworn to before me this (stamp or seal) :ts THE NEW YORK BOARD OF FIRE UNDERWRITERS J'-'- EUREAU Oj~ ELECTRICITY . 85 JOHN STREET, NEW YORK, NEW e.t. December 7, 1977 .) °nly the electrlcal equiprnent as~.describ~d below and introduced b. th'l'HIS CERTIFIES THAT Application ~o. o. /it. 9 ~ 7163 Oa~y Rose, ~ew Suffolk Ave., Matt/tuck, inth'followlngloca,ion: ~ B~emen~ ~ Ist$ ~ ~nd FI. wasexarninedon Deeembez, FIXTUEE OUTLEi'S SWITCHES DRYERS FURNACE gamage ~nd found ~o be i~ co~npliance ~vith the req~iret~er~ ts, UNII' HEATERS DIMMERS DISCONNEC] OTHER APPARATUS: 1-2 7o amps R Glenn R. Ho~ton must not be aJtered in any ~ Board THE NEW YORK BOARD OF FIRE UNDERWRITERS Dale 8 ~4ppllcatlon .No, o~ file only the elect~l equipment ~ described ~ and inr~uc~ by the applier ~d on the ab~ appl~etion number in t~ p~mises of Gar~ Rose, New Suffolk Ave., Mattituck, L.I. ' "Decembe~ ~, ~977 Electric room heaters: 1~1'.5~ Glenn R, Bradley ~ ~. Herren Ave. em~ ~ Mattituck, L.~I~ ~ 11952 Lic.122T 1 A~A~ This. certificate~ must not be altered in ..... any manner~ return to the office of the ~ard if incorrect. Insoectors may be identif~e~ b~ credentials. Disapproved a/c ........ ' .............................................. Application No ............................ APPUCATION FOR BUILDING II~RMIT a. This applicat.!~ must be completely filled in by typewriter or, in ink and submitted in triplicate to the Building Inspector, wltf~.;~ of plato, accurate Plot plain to Ical~ Fee according to schedule. b.. Plo. f p.I .on sho~?ing location, of lot a_r~l, of buildings on premises, relationship to adjoining premises or public streets areas, aha gWlng a detailed descnption of layout otpmperty 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 wor~ she. No .bUilding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy all hoge been granted by the Building InSpeCtOr. APPLICATIO~ IS HEREBY MADE to the Building Department for the issuance of a Building Permit pu~u~n., t to the B~uild!r~.. Zor? C)~d.. Inance of ~.he Town of Southold, Suffolk County, New York, and other appli.c, able Laws, O~,nances or ~<egulot,ons, mr trw Construct,on of buildings, additions or alterations, or for removal or demohtlon, as herein described The applicant agrass to comply with all al~)llcable laws, ordl~ncas~ building code, ho~stng code, and regulations, and tow admit authorized Inspectors on premises and in buildings for necessary Inspections. State whether applicant i~ o~ner~ I~see, ~a~Ja{t~t, en~in~r, ~eneml contractor, el~tricion, plumber or builder. If applicant is a corporate, signature of duly authorized officer. Plumber's License No ....... .......... Electrician's License No ............................................. Other Trade's License No ............................................... Locat on of land on wh ch -- -- '11 -- -- Man Nih- ~ ' - ' 1. prap~s~, work w.~J De. agne. ~ap .~ ......................... ~.....:~.~_~, I~O, ..;..; .................. Street and Number .~'l~.....~.~...~...~ ........... ~"~Nkmicipality ............... 2. State existing use and occupancy of/~) .(1^ '- . //'~P~'~rnises and~ intended use and occupancy of proposed construction: 3. Natu/~of, work (check which applicable): New Building.. ................. Addition .................. Alteration ...... Repair ' Removal .................. Demolition.: ......... ~ ....... Other Work 4. Estimated Cast ? ' ' Fee /~--~D~ (Description) (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 .i ......~ ......................................................................................................................... 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 sam, e structure with alterations or additions: Front .................................... Rear ............................ Depth ........ ........................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... ...~'7...~... .................... Rear .......-~....Y .............. Depth ....'~......~. .............. Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ ~l~qm~e of~ormer_C~vner ........................................................ 11. Zone or use district in which premises are situated ...~ ......... ..?.../....~....l.... .................... ~ ................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded __Y~: .......... WilLexcess fill be removed from premi,~,tK~(~ )lYes (~,.No ]4. Nameof ,C~,nerofprer~ses ..~.~..:..[~ .......... Address .....~(~one No ....................... Name or Architect ...... .~c..../.F_u.~.~ ......... ~ ......................... Address ..--~.. ......,~....,-~ Phone No ....................... · ...~....~..~.~.., ................... Address ~...~ne No..: .................... Name of Contractor PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and in~iicate all set-back dimensions fram 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~qD[~,~ COUNTY OF ~...~,~'~...~-~ .... ~' ................... ~~/ .... ~-~-Z.~ ................... being duly sworn, deposes and soys that he is the applicam (Nam~f indiv~ual ~g~m~trac~ above name& 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 all statements contained in this application are t~e to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this .................... ......... , ......... .......................... ~. 52~643721, Suffolk [erm ~pi~ M~rch 30, THIS SURYE¥ IS A ¥10LA'~IOH OF