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Home My WebLink About12672-zFORiR NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20921 Date AUGUST 7~ 1992 THIS CERTIFIES that the buildin~ Location of Property 11775 MAIN ROAD House No. County Tax Map No. 1000 Section 141 Subdivision ALTERATION MATTITUCK¢ N.Y. Street Block 4 Lot Filed Map No. Lot No. Hamlet 36 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 5~ 1983 pursuant to which Building Permit No. 12672-Z dated OCTOBER 10, 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 ALTERATION TO ENCLOSE EXISTING FRONT PORCH ON EXISTING ONE FA/~ILY DWELLING. The certificate is issued to of the aforesaid building. FLETCHER CHALMERS (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-242512 - JULY 17~ 1992 Rev. 1/81 FOF,.~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12672 Z Permission is hereby granted to: ...~.~.~....... ...... ~.~~ ~..~,~.... ~.~ .... ,~ ...~.~...:.~.,.~.......u.~.~'...~. premise~s j~ -- ----~-...........---- .- j-- .~.-..~. · ..:. -.--....;............. o, pursuant ',o application dated ,~..,~.,~.~.....-.'~,, ................ , 19~.,~t,., end approved by the Building Inspector. //~ f~u~ ding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN ~\LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 6. B. For 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. 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, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certifidate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions 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 g ......... ............ New Construction .......... Old Or Pre-existing Building. Location of Property,,,[/,ZZ,?>,~.' ~f,'~... House No. Street Hamlet Onwer or Owners of Property ....... County Tax Map No I000, Section .... Subdivision .............................. ...... Filed Map ............ Lot ...................... Permit No .... ~,~?.~..~,,,~.Date Of ~ermit,,._..,__..,-/z5 ~ ..Applicant .......... : .................. tlealth..Dcp~. Approval .......... - ..-- ..... .. · -..Uuderwritcrs Approval... .... Planning Board Approval ................. . .. .. .. Request for: Temporary Certificate ....... Final~Certicate.. Fee Submitted: $ ........... :.--]~ ... ............. C0 0q'o I INSPECTORS Victor Lessard Principat B~i~dlng Inspect0~ Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 ,3. OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 affL¥ 1, 1992 GRETCHEN CHAI3iERS 11775 MAIN ROAD HATTITUCK, lq'/ ] 1952 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) No Underwriters Certificate on file. The check is ,~a~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT % 12672-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS AGE [(~(~13E [ BUREAU OF ELECTRICITY ~ 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date JULY 17,1992 /IpplicalionNo. onfile ~3262792/92 N 242512 THIS CERTIFIES THAT o~y the electrical equipment ~ ~scribed be~w a~ int~uc~ by the applicant ~med on the a~ve application number in the prem~es of CHALMERS FLETCHER, in the following location: [] Bv~ement tt~s examined on JUNE 30 , 1992 ~(AIN ROAD, ~{ATTETUCK, N,Y, [~ Ist PT. [] 2nd Fl.' · Section Block Lot and found to ~ in compliance u'ith the requirente~(s ~f this Board ~' > FIXTURES C~KING DECKS OVENS EXHAUST FANS FIXTURE OUTLETS SWITCHES SYSTEMS NO. OF FEET C OF HI-LEG NO. OF NEUYRA[S OF NEUTRAL OTHER APPARATUS: PAT LANE EATTITUCK, NY, 11952 GENERAL.MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. FIELD INS?ECTION COMMENTS FOUNDATION (1st) FOUNDATION ROUGH FRAME & ?LUMBING 2nd) INSULATION ?ER N. STATE ENERGY Ye QODE FINAL ADDITIONAL COMMENTS: VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD DATE: ADDRESS: RE: BUILDING PERMIT SEC. /~ [ BLOCK This Building Permit has expired. violation of the Town of Southold Please contact our office, this matter must be corrected. ~ LOT J~ You are now in Zoning Code. Victor C. Lessard Principal Inspector q FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Approved . .(~5~..~.... I .t3..., 19~.-~. Permit No. ! .3r k.~..~:..~-.. Received .......... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..... I. 9.[ INSTRUCTIONS a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~¢ts.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. 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 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. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~. ~..Z~: ~.c.~..~'~..z~. ............ .v?/~. · ?'..~'..d'. .................... ............. ' (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 ...................... 1. Location of land on which proposed work will be done .................................................. .... . .,'?. .g. . . . ?. . . . . .............................. House Number Street Hamlet County Tax Map No. 1000 Section ..... ~[ ........ Block ....... ~: ........ Lot .... e~ ........... SubdNision ..................................... Filed Map No ............... Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constnlction: a. Existing us~ and occupancy ... /.~/ ..... &~ ~ ~ ~ ~ ~ ......... b. Intended u~e and o~cupan~y .................................................................. .. · 11. 12. Do~s proposed construction vie 13. Will lot be regraded ...... ~ 14. Name of Owner of premises .(~ Name of Architect ......... Name of Contractor ........ 3. Nature of work (check which at~plicable): New Building Addition Alteration Repair ............... Rem6val .............. Demolition .............. Other Work : ~i (Description) Estimated Cost . Fee i (to be 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 occupancy, specify nature ~tnd extent of each type of use . ~'~,~,~.2,4...(9 Dimensions of existing structures, if any: Front.,~ .~.,. ,~ .......... Depth ............... Height . .............. Number of Stories.....'~-'",",",",~ .......... ..,. ~.~ ............................... Dimensions of same structure w)th alterations or additions: Front~ .... Rear .................. Depth ' Height Number of Stories Dimensions of entire new construction: Front .... ,~.. ~.2f~Zr.. Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ~f_,~..~~... Rear ...................... Depth ...................... Date of Purchase ....... .//.~f,~.~.3..~. ........... Name of ro,,~ner Owner ,,e-~.~. f2~fff..~.. Zone or use district in which pr ~mises are situated. ~.~r-~.m..<,:p ....................................... ,ate any zoning law, ordinance or regulation: ..,~..0 ........................ '~,'~ ~0.~,.,,, ............. Will excess fill be r~moved from premises: Yes .(.~//,,q'd.~..~..~f.. Address~.:.:.:.:.:.:.:.:.~..,~..~..,~:f,,A'Tf~-'-~hone No..~..~.. 7~/¢.../.'.~.. ................ Address ................... Phone No ................ ................ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al1 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 ~orner lot. STATE OFNEW Y~OR_K~, . COUNTY OF... J'.~.~..r-~./-..~' ...... iS.S (Name of individual sigrling contract) above named. being duly sworn, deposes and says that he is the applicant 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 applicationi that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manndr set forth in the application filed therewith. Sworu to before me this (Signature of applicant) SUFtVEY ~ FOR GRE TCHEN: ,¢H ER TOWN $OUTH L,O 1212015 Unauthorized alteration or addition to this survey is a sec~tion-7209 oF the New York State Education Law. -~opie~ o~ this su~ey map not bearing the I~nd ~u~eyoCs seat or embossed s~[ :h~]l not ~ considered to be a valid copy Guora6tees ~r c~',~r,lca ns indicated hereon sh ..~.~--'r oil run only o the ~y~ ..... or wn ...... ~ ,rye>, ,s prepared, ~nd o~ his ~halF to onal ~nstitution~ or subs~uent owners. REFERENCE eUARANTEED TO= TIlE TITLE GU,dR,aNTEE COMP, aNY <;RET¢IlEN CH4LMER$ ' 1; FOUi~mA~ION '- TWO- REQL~IRED ....... FOR P~U~-E~D-CONCRETE ~ ~OUGR ~ E~MI~G 3. INcUI 'A~N 4. FIh'~ - r~N'~IRu~TI~N MUST THE-R~q'.L~5:~E~TS OK-~ N. ~. STA~ C~TRUCTIO~ & ENERGY CODES ' ~mT RESPONSIBLE FO~