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Home My WebLink About10506-z.% FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall SouthoJd, N.Y. Certificate Of Occupancy No... z:. 69.3.9 ...... Date . .4.u.v,e.. J.,..[~?.8 ................ THIS CERTIFIES that the building ADD I T I ON Location of Property 4050 Camp Mineola Rd. Mattituck, N.Y. hgd~ )vo: ................ 's'tle3i ...................... h3d, iei County Tax IVlap No. 1000 Sechon ... ! .2.3 ...... Block ...5. ........... Lot .... 2. 9 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Apphcation for Bmlding Permit heretofore filed in thru office dated November I 7, 1979 pursuant to wl'uch Building Permit No. 10506 Z dated . pece. m..b.e'.r..4....1.9.7. .9 ...... was issued, and conforms to all of the requirements of the applicable provimons of the law. The occupancy for which tlns certificate is ~ssued is ......... MASONRY CHIMNEY ONTO EXISTING DWELLING The cert~ficate is issued to PATRICK B. HANNON & MARY ANN HANNON ..................... ?oYn'oL'rg~'~'t) ...................... of the aforesmd building. Suffolk County Department of Health Approval ...... N./..A .................. UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING P~RMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTI-IORIZED) N? 10506 Z Permission is hereby granted ........ .. ~.. ~.L... Z~.-~ z ~.c~.... ~zzc~ ~ ~ .... ..... ~..~./z.(~. ~ pr~m~s ~o~ted ~ ~.D..Q......O~2.~.~.~....~ .............................. ............................................................................................................... pursuant to opplicot[on d,ted .... ~ .............. ~ .... ond Building Inspector. Fee $ Z..~. ~.. ,...'Z.. ....... TOWN OF SOUTHOLD :~!t~I ~,~rt I O1~ Building Depar~men, ~;~; ........... , Town Hail "' APPLICATION FOR C~RTIFICAT~ OF OCCUPANCY Instructions ' ' A. Th~; ~p3fic~on must be filled in typewriter OR ink, and submitted in dupficate to the Building tor '.v~ [he following; for new buildings or new usg: 1. F{nel suPzeV of property with accurate location of aH buildings, property lines, streets, and unu~al nn~uroi or ~ooo~raoh~c f93tur~s 2. F m21 a22roval of Hea th Dept of wa~er suop y and seweraae d~-o~j zc ~ ¢ 3. Acpro,/ot or eiec[r~cal mstsllauon from 8oerd of Fir9 Underwriters. q 4. Commerclal buildings, Industrial buildings Mutdp~e Res~ences and sm ar buiMin s and n tion,, a c~rt,ficate of Code compliance from the Architec, or Engineer responsible f;r the 5. Suom~t P~3nning 8oard approvg of completed site plan requirements where applicable. Cc~ ex,sung buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land u:es. L Accura~ ~p/ey of peoperty showing all prooertv lines, ~reets, buildings and unusual natural or tOpOEr2Dh~¢ features. 2.Sworn f[atement of owner or previous owner as to use, occupancy and condition of 3. Oa;e of ;ny housing code or safety inspection of buildings or premises, or other pertinent Jnforma- t~o~ requrred to prepare a ce~iflca~e. C. Fees: 1. C~rd,,caL oF occupancy $5.00 2. Cer~mc~te of occupsncv on pre-existing dwelling or ~and use $5.00 3. Cop,/of ceruf¢ca~e of occupancy $1.00 ,.. NewBuddmg ............. O~dorPre-exisdngSuildm¢(%)._.~ --=/Vscan~Land ............ ............ ~ ....... ~ ............. ~/¢~/~ ~V Owner or Ownars of Property ~'~ [( ~ ~/~ ~o ~ Counw Tax 6.1~o No. ~000 Section ......... B[oc~ ..... ~ Lot ~ ~ SUOalV,S~on ................................ m edMapNo, LotNo Hea~ Oep~ Approv~ ............ ' ............ Labo~ O~pt. App~ova~ ..................... Pbnnmg 8oard Approva~ .................. ~ , ~es and regulations. App cant ' ¢ ' ., ......... /..%t~ .~~ ........... ...._c~ ).b~ ~ -- FIELD INSPECTZON COMMENTS FOU~AT~O~ (~s*) FOOmDATION (2nd) ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY co~E FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approv . . 7. ...... ,1977. Pe mit No. r:. .O. isa p oved a/o .... ;:_. ..... ......... ......... /, APPLICATION FOR BUILDING PERMIT Application No./t~'.~.~..~..~. ....... INSTRUCTIONS a. This applicatmn must be completely filled in by typewriter or in ink and submitted in triplicate 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 drown 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 apphcation, the Building Inspector will issue a Buildirlg 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 fox, removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buil~,g)ode, housin~g code, and regulations, and to admit authorized inspectors on premises and in buildings for [tecessary in ~,~ ~il[nature of applicant,~gr name, if a co po ' ) (Mailing a~tdress of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ........ .................................... . .. Name of owner of premises,..:~.~.']~. ! ?).4...~.... ~.A?.O..~...~.~....~..~..~.~. .~. . ~....tq.o..~. .......... (as on the tax roll or latest deed) If applicant is a corporation, mgnature of duly authorized officer. ........................................... (Name and title of corporate o~i~) Plumber's License No ...................... Electriman's License No ....................... Other Trade's License No ..................... 1. Locahon of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Sectmn .................. Block ...~....0..9 ......... Lot...~..~-..o.:...C~O... ...... Subdivmion ................................... 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 ......... ~ .................... ~ .......................... b. Intended use and occupancy . . . ~ .................... (~ ......... ./ ..... -. ~ ?~..~ ........ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work .C~ff'/PI ~' i ~ -- ~ (Descnpti/°n 4. Estimated Cost . c:4...t3~. .......I ....................... Fee .. ,. ........................... 2-t-~o/ / ; (to be paid on filing this application) 5. If dwelling, number of dwelling un s ............... Number of dwelling units on each floor .............. If garage, number of cars ............................................. . .......................... 6. If busine{s, commercial or mixed ~ccupancy, specify nature and extent of each ty~pe of use .... .--'. ........ '. 7. Dmlenslons of existing structures ,~f any: Front .... ~r..~9.. Rear . .~..)A.. Depth. Height ......... Number of Stone ........................................................ Dmlenslons of same structure with' alterahons or_addatlons: Front ...~..~. 8. Dimensions of enBr.o new construction: Front .... ./.~. ........ Rear ./.~. ?. ......... Depth ./..~..7. ......... Height ~'. ~.~. ....... Numb0r of Stones .................................................... 10. Date of Purchase ..... ~. q ./(f. ~. .............. ._~lame of Former Owner ../~.~. ~ .~]O.O ~.5. ............ 12. Does proposed construction violat,~ any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... .,./M. 0 ...................Will excess fill be remove~d from premises: Yes _No Name of Architect ........... ' ................ Address ................. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Gave street and block number or description according to deed, and show street names and indicate whether interior or co~ner lot. STATL OF NEW ~ORK COUNTY OF .~.[:..~4..~t.O..~!¢ S'S {)~q T'l~ ~.l< b/~ ~J~J ~ 'b./ being duly sworn, deposes and says that he is the applicant (Name of individual signing 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 apphcatlon; that ail statements contained in th~s apphcation 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. Sw0m to before me this .......... ,' .......... /) I ~ua~lfled m New York County .... r ......................... , ' C~mmlssmn Expires March 30, 19 ~] (Signature of applicant) ,,Q l a.y · £ Inod '/ri .00, 61' o f' 'iv