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Home My WebLink About11610-zFORM NO. 4 TOWN OF SOU~'FIOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. g.1.1.046 .......... Date ..... Ju~e. :~5 .................... t98..2. THIS CERTIFIES that the, building ................................................ Location of Property 435 ........... Eastward Court Mattituck House IVo. ' ........................................ Street Ham/et County Tax Map No. 1000 Section , .1.1.5 ....... Block .. 0.7. ............ Lot ... 1~.0.9 .......... Subdivision..E.a.~t, Wp..rd..[Hg.n. or .Filed M~ip No. 5606 .Lot No. 9 conforms substantially to the Application for Building Permit heretofore filed in this office dated · ...~.Rt?.:[.. ~..1., ......... 19 .8.2. pursuant to which Building Permit No .... 116.19..7. ..... '. i... - dated ....Ap.rt~..1..2 ................. 19.8.2. , 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 ......... .... a.n...a.c.c.e.~.~.p?.y' two-car garage building. The certificate is issued to Et~gene Pearson few. er, ~&,:~'~4~ ...................... of the aforesaid building. Suffolk County Department of Health Approval ..... ~,/ia .................................. UNDERWRITERS CERTIFICATE NO n/a Rev. 1/81 Building Inspector BUILDING D[PARI~ME~T' TOWN HAL[ · ~ SOUTH'OLD, N, Y. (THIS PERMIT MUST BE KEPT ON THI~, PP, EM:ISES UNTIL F~LL COMPLETION OF THE WORK AUTHORIZED) ~. ..: .,...:. No. ~i~o z ~o~e '"""ii ( 'Il Permission'~ is hereby granted to: .......... tO Building Id~spector, Fee ~..!.~ !~.~. .... at peemise$ located at .... '"~ ................................................................................... :':" "7'?'''r .............. ..,~~...z..W.~.~.~..,...,.~..~ ~.. ....... ..... County To~ Mop No. 1000 .... Re~,. 16/30/;80 .~' ond ~pproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor 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 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 peoperty showing a~l 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ..... New House No, Street Hamlet Owner or Owners of Property ' ' County Tax Map No. 1000 Section .... ,~?..-~. ...... Block ...... .~. ...... Lot ..... ~¢'.~' ........ ............ Filed Map No,,¢?~.,47'~¢~,. '~.Lot No .... ~ ....... Health Dept. Approval ........................ Labor Dept· Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate................. Fee Submitted $.. Const/'uctioo on above described building and permit~mee~,s all app~cable~code¢ and regulations· Applicant., .... ,"- ~/;~~X- '~;~~ · .., ..... COMMENTS FIELD INSPECtiON 1. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~?DE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN CF SOUT'.qOLD BUILDING DEPAR'rMENT TOWN HALL SOUTHOLD, H.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT App,lication No.. Z/..~. ./..~. ..... Date ..... ~.'/~ ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi~. Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan ' ' ~ ~ ~o.wno location of lot and of buildings on premises, relationship to adjoining promises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part ~this app~ cation. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon apprc.'al of fids application, thc Building Inspector will issue a Building Pe~it to the applicant. Such pen:~ shall be kept on the premises available for inspection throughout the work. e. No buikliag shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant shall bare been granted by the Bnilding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pe~it pursuant to t} Building Zone Ordinance of the Town ~f Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describer The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, ~d regulations, ~d admit authorized inspectors on p~:miscs and in buildings for necessa~ iuspections. (Signature of applicant, or name, if a corporation) ~ r(Mailing address of applicant) ~ State whether appIicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buitd~. Nmnc of owner of premises ...~.~.~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... .~. ~..~ ............... Plumber's Licens~ N,-n '~-- Ek:ctrician's License No.' ...................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. .,~'. ..... House Number ~ ~ Street ~,-~~ '' '~'1~ '~d~/~/;~ ...... County Tax Map No. 1000 Section .... ~4~ ......... Block ..... ~ ........... Lot... ~ ............ Subdivision.. ~/~a~/'. ~?~ ~ .......... Filed Map No. ~.~W~ .... Lot...~ .......... (Name) 2. State existing use and occupancy of premises and intended us~ and occupancy of proposed construction: a. Exis ng us= and occupancy ......... ~. ~_ .................................... .~b. lntended use ~d occupancy . ~ .~ ~O~ ~e ' ". ,. ~ $. Nature of work (cheek which CpplicabI : New BuLlding .......... Addition .......... Alteration Repair ............. Removal..} .., ........ D,',rnolition .... ........ Other Work ~..e~..~.,g'.~'..~'.ff...e- 4 Est/mated Cost .... "'"'i'"'' ............ Fee .../.Q) .......... ; ....... .~. .......... 1 (to be paid on filing this application) $ If dwelli,'~g number of d~velling units ~ Number of dwelling units on each floor Ifgarhge, number of cars ...~..~...~ ........................................................... 6. If business, commercial or mix'ed occupancy, specify h0ture and extent of each bpe' of use 7 Dimensionsofexistingstmctu~es fan~ Front ~ Rear D~pth ............ Hmght ............... Number et ~tories ............................................. Dimensions of same structure {vith alterations or additions: Front ................. Rear ............... Depth ................... ;... He~t ...................... Number of Stones ................... ~. Dimensions of entire new construct on' Front ,~ ~ ..... ~ ' Depth . ~ .... He ht ...... ~ ~ .... NumbeLo[ $ odes .... ~ ....... ............................... ~ ......... 9. 8iz. of lot: Front ........ ~.~.'.5 1 ...... Rear ..... ~ff ... D*pth .~ .'-.~;~.~.. II. Zone or use d:stnct m which p~emises ~re s tuated ":- )2. Does proposed construct~o~vlolate any~zoning law, ordinance or regt Iation: . ~ ........ t3. W I et be regraded ~e..;..' J - . . Will excess rill be v " · ' .... ~ · · · · ,. ~ ......... ~ , .,remo ed from premzses. Yes (4. Name of Owner of premises ~/.eO~] .~¢~. Addr:s~e~ff~.~h'one No~-~. Name of Architect ......... i ....... , . , ,, . .~. ~...'..~ddress .................. Phone No ............... Name o~ Contractor .~~..~ ~ .~. ~/~Address ~/~'~/~/~Phone No PLOT DIAGRAM Locate clearly ~d distinctly Mil at iklin gs, whether existing or proposed, and. indicate M1 set-back d~:nsions from property ~nes. Give street and bloc~ number or description according to deed, and show street names and indicate whether ~atedor or Corner lot. ~TATE OF NEW~ORK, a , ..... i.. - lng duly sworn, deposes and say~ that he is the applicant abm'. nam~ ofimli,:~ign~ng con act) I~e is the ...................... ~ ' ' ......... day o(.,. .., 1~ · , ',,': '"'~. ~ .... .:.-?. ~.,~T}',.:~ ::1 L 0 .5~3,:.,. ',.: (Signature of applicant) ,¢ 76§-7802 9AM TO 4 PM FOR THE FOLLOWING ). ~UNDAT~ON- ~0 REQUIRED FOR POURED ~ONCRETE ~, ROUGH - FRAMING & PLUMBING 4. FINAL - CONSTRUCTION MUST BE COMPEETE FOR C, O. ALL ¢ONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N. Y ~ATE CONSTRUCTION & ENERGY CODES.' NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ER~q