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Home My WebLink About12110-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ....A .C.C.E. 8. ~ .O.R.Y., .~.A.R?. O..E .......................... Ln~atlr~nr~fpvr~n~rfw 2855 Westview Drive Mattituck, New York County Tax Map No. 1000 Section ...I.0. 7. ...... Block ...0.8 ........... Lot ..... 6. ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .D.e.c.e..m.b.e.r...2.?.,.. ! 7.8.2. pursuant to which Building Permit No. 1 2 1 10 Z dated ..........Jan u a r y .... I/4..... ,..' I 98 3 ..... . 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 AS APPLIED FOR' The certificate is issued to IRENE & FELIX BIALESKI ..................... x .................... of the aforesaid building. Suffolk County Department of Health Approval Iq / A UNDERWRITERS CERTIFICATE NO. N 70 8 8 6 7 N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 12110~ Z BUILDING p, ERMj*I (THIS PEPJ~IT must BE KEpT OH ?HE pl~Ei !~ uNTIL ~ULL a~p remises located at Couj~ty Tdx Map No. 1000 Sectio pursuantt° application dated ................ ,...:....,~.,, B~ijl~lng I~$pector. . R~y.~6/30/80 and ~pproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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 c, ompleted site plan teqbirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZOperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 ~2255 0000, ~y $]0.~ 1. Certificate of occupancy New Dwelling .' Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 e,, >. . /, ' ,, / // NewCOnStruc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Lo,a, on of ,roperty ............... /.¢. :Z... Owner or Owners of ~roperty :. . .... ~ ........................... County Tax Map No. 1000 Section ............... Block ............ Lot ............ Subdivision ....................... A ...... ,~..Filed Map NO ........... Lot No .............. Permit No/?..//..~. ..~. Date of Permi ' . .Applicant Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... ~equest for Temporary Certificate. .................... Final Certificate ....................... Fee Submitted $... ~.~.; .'.~. ................... Construction on above described building ~it meets all applicable codes and regulations. Rev. 10-10-78 THE NEW YORK BOARD OF FliRE UNDERWRITERS BUREAU OF ELECTRIC~IT~ THIS CERTIFIES THAT only tke electrical equipment as described below and int~duc~ by the a~l: ....... ~-~-- '~ ~ ....... ~el~,~ ~ial~i, Sr~ ~ W~s~biew Drive(Gr~d in the following location; ~ Basement ~ 1st Fl. was examined on ~.~.~X* 11~ 3,9~5 FIXTURE OUTLETS [] 2nd FI. ' Section Block and found to be in cornplla~ce wltlt the r~qulrernents of this Board. ~ECEPTACtES SWITCHES FIXTURES RANGES OVENS FANS Lot DRYERS FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI.OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT 11952 most S E R : I NO. O~C. kCOND. A.W. ~ OF CC COJ~O NO OF HI LEG C E A W.G. NO OF NEUTRALS OF HI-lEG AW, G OF NEUTRAl return to the , ofth~ Board if Inspectm ' GENERAL MANAGER Per may be identified by their credentials. I?IELD ]NSPECIION 1. FOUNDATION (1st) COM~ENTS FOUNDATION (2nd) I!ONGH FItAME & PLUMBING INSULATION PER N. Y. STATE ENERGY G,OI) E FINAL ADDITIONAL COMMEN~S: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ~/~. / ~.., 19 .~...~ ,-~ Application No./~..//..(~. ........ Disapproval a/c ...... :~ ............. r7 ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .../. ...... 1 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 bef~ore 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 ~6 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 i~pec$,ijIbns. (Si~fTap~licant, or name, ifa (Mailing address of applicant) State whether applicant i~ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... .O..W..m X: ........................................................................ Name of owner of premises .. .~.~.~... /.~.ff-.~'./.~5. l. ............................................. (as on the tax roll or latest de~d) 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 .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ..... [.0..~ ....... Block .... . .~...~.. ....... Lot... ~.~ ........ Subdivision ....... ~(. ............................. 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 ..... ~..O...?~..t? ...................................................... 3. Nature of work (check which a~plicable): New Building . ~ Addition Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... ~_ (Description) Lst~mated Cost ............ ......................... Fee ........ ~ .......................... (to be paid on filing this application) 5. If dwelling, number of dwelling u..~nits ............. Number of dwelling units on each floor ................ If garage, number of cars ....................................................................... ~ 'J 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 .... ~ if any: Front Rear Depth · I)~mensmns of ex~st~ng structures, . ........................................... Height ............... Number of Stories...' ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i · · Height ........ ~ ............. Number of Stories ...................... 8. Dimensions of entire new construction: Front ... ,g. .......... Rear .../g; .......... Depth .,2 ~. .......... tteight ............... Number of Stories ....................................................... 9. Size of lot: Front .../~.~...i ........... Rear ~O D . ./. ................. epth .. / ................... 10. !)ate of Purchase .. ~.~'.~4~.~...: .................. ~me of Former Owner . .~'63~.5'.~.~ . i~.~.C~. . 12. Does proposed construction vio!ate any zoning law, ordinance or regulation: .,~"..O. .......................... 13. Will lot be regraded ....... ., · ............. ; ..... Will excess fill be re. moved from premises: Yes No · .. Phone No. ,~.~' ............ 14. Name of Owner of premises -~/L~./5 t'/} ~ g. t... Address .Ylx,9..T~...t~.. ..... Name of Architect .......... ' ................. Address ................... Phone No ................ Name of Contractor . ~.~.~-A<g'~ ~..~¢/~,(C o ..... Address ~ x~.~-TT.*,t ~ ...... Phone No.~, F?.-~ .~..~. ~.~2... PLOT DIAGRAM Locate clearly and distinctly alii 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 NEW~..R~4,/, ~ .~/ S.S COUNTY O~~.~.. , ......... ........................................ being duly sworn, deposes and says that he is the applicant (Name of individual sigr ing contract) above named· He is the ...................... , ................................................................... : (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application am true to the best of his knowledge and belief; and that the work will b~ performed m the manner set forth in the application filed therewith· Sworn to before me this ~f ............ :day 19 : flot~ Cubl~e, S~at~,,,d/~°n~ ~ ~.~ ~ (Signature of apphcant) ~m~iSsion Expires March 30, 1~ c~ Sound Avenue Mattituck, New York 11952 (516) 298-8440 t/