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Home My WebLink About12658-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16976 Date June 13, 1988 THIS CERTIFIES that the building P o o 1 Location of Property .. 2350 Wickhara & 55 Bayer Road Mattituck House No. Street Ham/et County Tax Map No, 1000 Section ..... ! ,3,9 .... Block 3 .Lot 9 Subdivision ............................... Filed Map No ......... Lot No .............. conforms sabstantially to the Application for Building Permit heretofore filed in this office dated .... .S.e.p,t. :..I.0. ,...1.9.8.3. pursuant to which Building Permit No... 1.2. 6. .5.8.Z. ............ dated Oct. I, 1983 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 ......... .... .Ln. gr. 9.u.n,d.. p9.o.[...a.s..a.p.p.l.i.e.d., .fp.r... .................................. ' ....... The certificate is issued to RICHARD & JO ANN TAND¥ ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ~ /A UNDERWRITERS CERTIFICATE NO. Pending 6/6/88 PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FOI~ NO. ~ TO~N O~ $OUTHOL~ ~UILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12658 Z Permission is hereby granted to:. ~ · ~ ' ~^ ~'**':'*:'~'~2~'? .......................... ..~/...L l..c:~-~ ...: ~ ............................................. .... ~~~,..~.:..~.:....1.~.~.~:~__ .... ~~....~....~~~ ........... ~ ................... ~~ ...... ~.~., .................................................. ; .......................... .~.~ ~~' ..~..... at premises I~ated at .,~.~,~,,,~.~.~.~,..~.~,-~.~...~....-~~ co~ *~ ~p ~o. ~oo s**~o~ ..... /..~ ......... ~k ........ ~ .......... [o~ ~o ..... ~. ................ Bui~din~ Inspector. ~,1. .~.. ................. Rev. 6/30/80 TOWN OF SOUTHOLD FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ 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 Hea{th 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing ail property lines, streets, buildings and unu~al 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre~existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.0/0 5.Updated C.O. $ 50.00 Date ...................... NewC°nstz"uc%ion ...... O~d or Pre-existing Building ............ Vacant Land ............. Location of Proper . .... House No. Street County Tax Map No. 1000 Section ............... Block ............... Lot ............... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No ........... Date of Permit .......... Applicant .' .~...~.~'t~.' .~... Health Dept. Approval ........................ Labor Dept. Approval ..................... Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ .... ~. ,'3.., ................... Construction on above described building and..Qp~mit meets all ~ .~.e ~codes and regulations.App cant .~. ?.-~. Rev. 10-10-78 FIELD INSPECTION FOUNDATION (Ist) FOUNDATION (2nd) R,OUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY ODE FINAL COMMENTS ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 This is Co advine you that the job under building permit no. 1265BZ issued to ,Richard Tandy on --L0~.~3_~_ ~or A_Q.C~.~so~y is eompt~"ted and a final ~nspectxoe has ( ) has not ( X ) 'been done. A complete Underwriters Certificate is required ~n order to complete thi~ file, it' is necessary that a CertJficate ef Occupaacy be issued. Please fill out the enclosed form, return same to the above office with a cheek for $19.00 payable to rile Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange wl~h this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us to clear np thi~ matter so that legal action does not have to be taken. Thank you for your prompt attention. Vary truly yours, Victor Le~sard Executive Admlnlatrator VL:gar encl. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ '~j~FINAL .AT' ~///? Examined...O.~. !. Approved . . . .O7.~..[. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 ., ., 19~'.~. Permit No. I .~..tp.~."..~.:~:. Application No ............... '... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 of property must be drawn on the diagram which is part of this appli- cation. e. 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 issued a 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 building for necessary inspections. State whether applicant is owner, lesse~chitect, (Signature of applicant, or nmne, if a corporation) .... ....... (Mailing address of applicant) engineer, general contractor, electrician, plumber or builder. Name of owner of pre is ...~...,..-.: ........ .................... ,/ ................................... (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 License No ......................... Electrician's License No .... /~., .~.. Other Trade's License No. ~°~s> . .-7~.._~'- ~ /./ /~/ -~-~' ~ /7/ 1. Location of land on which proposed work will be done.. ~.~./.' ~./.~.~..'~..'~......~.....~Jp~.. ~.~.~..F~-.. ??~.C/~ .-~.. ....... House Number Street Hamlet .County,ax Map No. i000 Section2...I. .S .... lock ....... ......... Lot....?. .............. 'Subdivision..~.~..~..':~'.~'-/.~:~ &:.'7.¢.).'~ ~ ..... Filed Map No, .. ~ ]."~, .~. ..... Lot .~.8.'?.a..~??-.~.~.~.~ (Name) 2. State existing use and occupancy of~remises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... :. :. .... ~ ....................................................... b. Intended use and occupancy .... :~..~:....-'~.../= .~..c.4.~.. '..~.....~--..~../~...C~....:-~.. .................. ..... 10. 11. 12. 13. 14. Nature of work (check which applic:able): New Building .......... Addition .......... Alteration .......... Rep-'dr .............. Removal .............. Demolition ............. Other We rk~/~.~/o~...t~r,~ Estimated Cost .............. Fee ............ .~ ............ / (to bo paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor... "' .... If garage, number of cars ....... ~ .............................................................. If business, commercial or mixed o~cupancy, specify nature and extent of each t~e of use .. ~ ..... '..~... ~b~ensmns existing structures, ~f any: Front ........ Rear . ~ .~. ......... Depth .. ~ ...... Height ..... n..:. ..... Number of Stories ..... ~ ................ Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth... .................... !Height ...................... Number of Stories ................... Dimensiohs of entire new construction: Front ............... Rear ............... Depth ............ lot: Front .... Rear.. ~. ............ Depth ..../..~..7. ............ Date of Purchase ~dC-~. :z. 7 -2 ~ Name of Former Owner Zone or use di tri t in which p m~se it ated s c re s are s u ..................................................... Does proposed construction, violat~ any zoning law, ordinance or regulation ........ . . ..... Will lot be regraded ... ~/~d.~ ;o;,.i'... ', .......... ),Z' Will.~xcl~s.fill be removed from premises: Yes Name of Owner of premises lc.'.c.tq. .~(~4.0-..'-J. ff..~.~.. Add~s ~..u.v. . .t~. :~ .F--./T..~L'~.: ~ Phone mo~..qj~.-7~/~. ~. .... Name of Architect ........ ...__. ..,,... .............. Address ................... Phone No ................ Name of Contractor 3!/x~.. .~.~. ~...~.. ag:. _~,q..ri.r. Address ~ :~.~/...~..~.:../~ .l~?'Phone No. ~)r..~. ~.2~..( .O. 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 NEgi-Y-OI~Ko , · COUNTY OF . i'~ ~..'.~!/.~ .-7-. ,'S.S ....... t ~._~_~~ .... , ~.~.[~t q..~.N ....... being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. , He is the ................. . (Contractor, , etc.) rpor of s~d owner or owners, ~d is duiy authored to perfo~or have peffomed the said work ~d to m~e ~d file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will'be perfomed in ~e m~ner set forth ~ the application fled therewith. Sworutobeforemethis ~~ ...... /. .... ........... / Nora, Public, ~ ~~ .......... County __, ~ / ~