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Home My WebLink About12802-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17417 Date OCT. 14~ 1988 THIS CERTIFIES that the building_ ACCESSORY Location of Property 1295 ELIJAHS LANE MATTITUCK House No. Street Bamlet County Tax Map No. 1000 Section 108 Block 04 Lot 7.7 Subdivision ELIJAH8 LA EST Filed Map No. Lot No. 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/7/83 pursuant to which Building Permit No. 12802Z dated 12/15/83 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 & STORAGE BUILDING. The certificate is issued to PETER & JUDITH VICTORIA (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N623127 11/11/83 PLUMBERS CERTIFICATION DATED N/A 'Building Inspector Rev. 1/81 FOBI~ NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12802 Z Permission is hereby granted to:---. . ..... ~~....~..~.../~: .~.~ ......... ..... ~:.....z:~. .......... z.z.~ ................. ..... ~.z~.z~/....~..~, ...... z..~ ,, ........... ~ ~. ~.~z~ ~..... ~a a ~~ ....... ~~...~t. { .~~ ..~.~.~z~ ............................................................................................................................. ,, premises ,~e,ed ~, ....Z~ ....... ~/~ ....... /~'Z' ........................... ~ ....... .................................. , ................................................................................... ~~.¢Z.....z~-~ ' ~" ~ .... Z~ ~C ,~~...Z~.....~~ ....................................................................... / . Co, n~ ~x M~, No. ~000 Se¢,o, ..../~ ....... ~,~ .~.~ ......... ~ ,o....~a.Z....~ Building Inspector. tor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 18.02 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 unu~al 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, Multiplo Residences and similar buildings and installa- tions, a certificate of Code complianco from tbe 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 sun/ny of p:oparty showing all propertv 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 pertinont informa- tion required to prepare a certificate. C. Fees: 1. Certificate o[ occupancy New Dwe[l[n.~.$25.00. ^cce.,eory :$10.00 Buniness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certJficate of occupancy $ 5.'00, over 5 yearn $10.00 4.Vacant Land C.O. $ 20.00 /.O.//.V../.~.~' 5.Ur~dated C.O. $ 50.00 {)ate .' ................ 6. hlteration $25.00 NewCons truction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .................................................... ; · House No. /~ Srr#e,t Ha/n/er Owner or Owners of Property ............................................ County No. 000 Saction ...... .... W. ........ ........ ~ubdMsmn ...................... ed Map No ........... Lot No .......... Permit No . Date of Permit, Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted Construction on above described building and p.e~mit meets all applicable codes and regulations. Apphcant..../.~..*~.. ~.... · .~..~ ........................... FIELD ~SPECT ION 1. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY ADDITIONAL COMMENTS: io~j~ob THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ ~ov~r ii~ is~'~JOHN STREET, NEW YORK, NEW yORK ,~.,e ~,o,~,i~,..o., ~o. o.~.~ ~/~ N ~ 2 31~ 7 THIS CERTIFIES THAT Petei' V~toria~ ~itj~ ~e, ~ttitu~i, in the followlng location; ~ Basement ~ lst Fl, ~ 2nd Fl. Section Block Lot was examined on ~0~'~'~ ~ ~ l~ and found to be in compliance with the requiren~e~ts of DRYERS E R I C E OTHER APPARAI'tJS: Panol~ard~; 1-,2oir. ,lOO~s. John Cut '~x)~ue: N.Y. Lic#~OOOE This certificate must not be altered in any manner; return to the office of the Board if COPY FOR NG DEPARTMEN¥. THIS COPY OF C~ER'I' Inspecto~ may be their ~ MANNER. TOWN OF SOUTLIOLD OFI'ICE OF BUILDING INSPECTOR ii.O. BOX 728 TOWN IIALL SOU I'IIOLi), N.Y. 11971 113o TEL. 765-1802 To Whom This May Concern, We are unable of Occupancy because .of the following /_//An application for Certificate of · /'-Z :;o Underwriters Certificate on file. /_~ The check is~/not on file,)~F/0,(,~ /~/ }~o Health Dept. Approval on file. /~/ No final inspection has been made, to complete your Certificate Occupancy P]ease contact: our office on this matter. Thank you for your cooperation[" Buildin~r Dept. "**/_-/ Uo Ptember Solder Certificate on file. ( all permits involving plumbing bein~ issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [] FRAMING f~'~NAL ~~ REMARKS'- ~/~'~ ~ DATE 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: ~DATE INspECTOR / TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P,O. BOX 728 TOWN tIALL SOUTtlOLD, N.Y. ! 1971 TEL. 765dS02 This is to advise you that the job under buildlng permit no. 12802Z issued toP Victorza on ..~2J~5~B_3 .... for ._A_g~.e~_s0,ry is completed ;, fi. esl inspection has ( ) has-not ( x )'bee. do~e. and rn order to complete this file. it is necessary that a C¢'rtiflcate of Occupancy be issued. Please fill out the enc:losad form, return same to tile above office with a check for $10.00 payable to the Town of Sottthold. Please indicate to Whom the Certificate of Occupancy is to be mailcd~ and ;~rrange with this off{ce for an inspection date Occupancy or use in nnlnwft, l wlthout a Certificate of Oecupnney. Please help n. to clear up thie, matter so that lei:al action does not: have Lo be taken. Thank you for year prompt attention, Very truly your. g. Victor Lessard Executive Administrator VL,Lnr cncl . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined ~.~...../..~..- .... , 19 .~.'~ Approved ~.-~-~.. ¥ .~. ..... 1~..~. permit No./~(~..~. d.~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis 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, ~or 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, hous,~? code, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necessary i~i' .. ~/,~~ ~~ - (Signature oF applicant, or name, if a corporation) ... :4.. . .... ......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.../~ .,~......O[.~. f.('~ .................... (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 .... Plumber's License No ......................... Electrician's License No...~..c~>....~.. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...................... i ...................... ttouse Number /2..-~5'"" Street Hamlet County Tax Map No. I000 Section ..... /..O..?. ...... Block ..... .~. ........... Lot..7.'. 7. ........... Subdivision .~.. ,.ff, JI/~c... ~.....~... ......... Filed Map No ............... Lot ..... .~.. ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...../~f~. · ·.: .......................................................... b Intended use and occupancy 3. Natureofwork(checkwhichapplicable):NewBuilding ....~... Repair. ............. Removal 4. Estimated Cost .... ~..aAh. ,~...: .... 5. If dwelling, number of dwelling Units. ... Addition .......... Alteration .......... ............ Demolition .............. Other Work ............... (Description) ................... Fee..../~... (to be paid on filing this application) ............. 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 structure:s, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Numb?r of Stories ...................... .. Rear .... ~.~.~ ....... Depth .~..dt~';'. .... 8. Dimensions of entire new construction: Front .... ~..,... . ' 9* Height ............... Nmnber of Stories ......................................................... 9. Sizeoflot: Front ....................... Rear ...................... Depth ...................... 10. Date o[ Purchase ........... .................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ... ................. Address ................... Phone No' ................ Name of Architect .......... : ................. Address ................... Phone No ................ Name of Contractor ......... i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, an& 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 NE'?} Y.OrRK,, L , iS.S ' COUI~TY OF~ .... ..../~.e.~44~.'~...~ ~-./.b~..c'A'w~.... , .,............ · ....... being duly sworn, deposes ~d says that he is the applicant (Name of individual sign~ing contract) above named. He is the ~ ' (Contractor, agent, corporate 6fficer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application filed therewith. Swam to before me this ................... day of ....... 19 .... NOTARY PUI3LIC,! No. 52-4636~6~, Suffolk County~/ ...... / ...................... Commission Expirds March 30, 192~ (Signature of applicant)