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Home My WebLink About12787-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No...Z. 12244 Date February 6 84 addition to ac.c. essor.5( THIS CERTIFIES that the building ............................................. Location of Property 1330 .B.a~. Avenue . Mattituck House No. Street Ham/et County Tax Map No. I000 Section 143 .Block 03 .Lot 021 .. Subdivision.. ..... X. ................... .. ..Filed Map No. ....X . Lot No X conforms substantially to the Application for Building Permit heretofore fried in this office dated No..v.e.m.~.)er .22 8..3p 12787 Z ............... , 19. ursuant to which Building Permit No ...................... dated .... .D.e.c. 9.m.b.e.r...6 ............19.8.3., was issued, and conforms to aB of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issned is ......... an addition to accessory storage b. uild. i.ng. The certificate is issued to GEORGE E. SNIDER (owner, of the aforesaid building. Suffolk County Department of ltealth Approval ...... N.~A.. .............................. .. UNDERWRITERS CERTIFICATE NO ............. .N.§ ~.2.0.0.6. ............................ Building Inspector Rev. 1/81 FO~M NO. ~ TOVv'N OF $OUTHOLD E. IJtLDiHG DEPARTMEHT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12~$~ Z Date .............. ~.' ................................. . ...... Permission is hereby granted to: ~ ~..~../..~..' ....... ~-~.~.~.: ........ ~...<... .......... ~/~.. ...... ./.~.~.~. ....... ~ ............... ..... ,o . .~.~..~.~.z./~.~...c.F........~.,o~azz~. ..... .~......~. .................. ~ ........... .............. ~../.c~...~.~ ....... ~.~.~..z:~ .~..z~.~ ........................................................................ ~ . ~t premlses located at ......~.~-..,,':~. .............. ~..Z~..~........~.'.~7 ................................................... .................................................... County Tax Map No. 1000 Section ..... Z..~.....~.. ...... Block ....,~,.~.."~. ........ Lot No...~:/~./ ........... pursuant ,o application dated ~J~.~...~.~.~.~.~.: ...... , 19.Z,--~., and approved by the Building Inspector. Fee $..Z.(-~.. ....... : ...... Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 featu res. 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 / 2, Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O. $15.00 Vacant la~d C.O. $ 5.00 Date ..... ~. ~../..~.~. .......... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Locat,on of Property ........... ~OU~ fl'O: ...................... Street Hamlet Owner or Owners of Property ,, ~ ............... ' .............................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ....... ........./ ,.......PlanningBoardApproval ... ............. .... · · Request for Temporary Certificate ..................... Final Certificate................./ .... Fee Submitted $..~; ,~,. ,~, ................... Construction on above described bu ,ldin, a~lit meets all~l~ez.~ :g~ lati°ns' Applicant..~..g..~~'~.~l~, >/..~ · ,--z.~, · ,-;w ............ too129o THE NEW YORK BOARD OF FIRE UNDERWRITERS ns BUREAU OF ELECTRICITY ~ Ja=uar7 31, 19~4JOHN STREET, NEW YORK, NEW YORK 10038 ..re *,,,,,c..o. No.o./i,e 25~,06~-S'~ N 632006 THIS CERTIFIES THAT George Snider, Bay Ave. 1/6 mi. S/O Rt. 25, Matti~uck, N.Y. in the following location; [] Basement ~ 1st FI. [] 2nd Fl. Section Block Lot was examined on January 25, i984 and found to be in cornpliance wlth the requirements of this Board. OUTLETS 4 5 DRYERS FLUORESCENT SYSTEMS E R V I C NO OF CC. COND PER ~ A. WG OF CC COND. OTHER APPARATUS: 2-G~F.I. Panelboards: 1-6cir ~ !00amps. E~ec~rzc Room Heaters:l-2.0 K.W., 1-1.0 X.~. NO OF HI LEG OF HI-LEG NO, OF NEUTRALS AWG, OF NEUTRAL Ted Cheshire Jr., Co~ Box 255A, Sound Ave. MaC~ituck, N.Y., 11952 LiC.~953 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by th~ COPY FOR BUILDING DEPARTMENT. TH IS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. F~ELD~NSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PEN N. Y. STATE ENERGY 2?Dm FINAL ADDITIONAL COMMENTS: i ........ : ......... 7657t80[ 9 AL'~ TO 4 PM FOR TIlE FOLEOW!~ r~-~'~'-- ?''-~ ~- ..... FOUN ~ . . . ........ ~. ~ '~ ~/O REQU~ED ; ~OR POURED CONCR~E ~ [ , , , , -~ ~ _~HE ~EQU~E~'E~TS OF THE N_Y. ,§£'P9 ~,,Og,£/oO'~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Exam,ned' c~?C:C-../ '~- .~ ..... ,19 .Ff..~? Approved ~.~....( ....... 1~.~. Permit No...//.Q .~...~.7 Disapproved a/c ......... 7-. ............. ; ............ (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. 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 for necessary inspections. admit authorized inspectors on premises and in building ~//~,~_~p~._. ~- .'~..'~./~" (SignatUre o~f applicant, or name, ,f a corporation) .... tz; · ..... 7 .................... (~ailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· Name of owner of premises ..... ~· .~?.t.~..F~.~*...~' ...... .~-~. e*.~ ~ .~ff. Zl' ....................................... (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...../~.~..~M.~ ............. Electrician's License No.~.~.~... ~.~-~-.~. Other Trade's License No ...................... · .~. · ~.¢. 4 ................... 1. Location of land on which proposed work will be done.. . .~..~.~. ..... ~.~.f .... g -~ /77 ........................................................................... House Number ~ / _~'.~1~ Street Hamlet County Tax Map No. I000 Section ....... ./.~..~7 ..... Block ....... ~.,~ ...... Lot...~..~ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: · -~ ~., ~ ~ · a. Existing use and occupancy . . d~ t~.~,~.~. ..... ..~..~.t/~ r~.~. ~.~'. ;/../~.:~ ....... .7~. ~.~.~. ~ ...... b. Intended use and occupancy ,0. rr~. ~ ..... t~.t.~, fTr ......t~.l?~.t. J. ~ ~. .,~. ............................. 3. Nature of work (check which applicable): New Building p.q~.... Addition..fiq~ .~... Alteration .......... Repair .............. Removal ............. Demolition .............. Other Work ............... ~ . (Description) 4. Estimated Cost. '~7' ~?..o ........................... Fee. ~x../..~. .......................... (to be paid on filing this application) 5. If dwe!li~g, number of dweiling units ............. Number of dwelling units on each floor ................ If garage, num bet of cars .... ~ ................................................................... 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 same structure with alterations or additions: Front .... .............. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ......... , ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front . .~..~...$ fi.ti V't~.~. .... Rear ...................... Depth ...................... 10. Date of Purchase .......... i .................. Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..tM.z/ .......................... 13. Will lot be regraded ........ ; ............. ~ ..... Will exqess fill be removed~from premises: Yes No 14. Name of Owner of premises p.~.at~.~...~,~. ?.*.&. Address~. './~.~.,~.~..~IA~ ¢~.~.~Phone No.,~, ~'.~f..~.~..~-... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 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 ~orner lot. STATE OF'NE~Rtr~/~.~ .4 S o .... D_ 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 application; 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 manner set forth in the application filed therewith. Sworn, to before me this ...... ./7.~..~. ........... day of ....... ~.~..,~. ........... 19 .~/~ N ' x (Signature of applicant)