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Home My WebLink About10391-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22327 Date MAY 17~ 19.93 THIS CERTIFIES that the buildln~ Location of Property 410 AIRWAY DRIVE House No. County Tax Map No. 1000 Section 123 Subdivision ADDITION MATTITUCK, N.Y. Street Hamlet Block 1 Lot 2 Fzled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 5, 1979 pursuant to which Building Permit No. 10391-Z dated SEPTEMBER 6, 1979 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 ADDITION TO EXISTING MACHING SHOP The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED J. PARKER WICKHAM N-467147 - FEBRUARY 11~ 1980 Building fn~oeJto~ ' ; Rev. 1/81 l~O~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMI~NT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHOR,ZED) N°. 10391 Z Do~e .... ~ ...... ~9..Z.~ Permission is hereby granted to:,__~ / - , · . ~ // .........~~----~;~, ~ ~~.~..~. ~.'~.~- ,o ...~...~~~...~..~~~..,~ at premises located at. .~~'~'"'~~7" pursuant to application dated ...,.~,.,'.? ........................ , , and approved by the Building Inspector. Fee $.%*~.: ................. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 i% lead. 5. Comm~ercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For 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 Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. 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 ................................... New Construction .... ~.. .... Old Or Pre-existing Building .......... Location of Property ..... ~/~...t~..~.. ,'~ .~. ...... /~.~..~. ,~,/.~.'. ~.~,.. i i~t~,' · ................... House No. Street Hamlet Onwer or Owners of Property ..... ~..~/~~ ................................... ...~ [.~.~./~...~/~... . . .. . . County Tax Map No 1000, Section...~.~.~. ..... Block ...... ./. ........ Lot ..... .~.. ............. Subdivision...........,... ................. . . . . Filed Map ......... . .. Lot ..................... . Permit No..l.~...~..~. 1. .... Date Of Permit..~. {.~.~..~..~o..Applicant..-.~.. ~-~..~-.~..~...~ ........ Health Dept. Approval...... ................ . .. . Underwriters Approval ........................ . Planning Board Approval ...................... .. Request for: Temporary Certificate ........... Final Certicate .... .~. .... Fee Submitted: $ .......................... I TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECFOR ' po.~ , ~OX 728 TOWN HALL SOUTHOLD. N.Y. 11971 TEL. 765-1802 App!lcant T.zs z~ oo a~v~oe you that the ~ob under Bui~dzn&~ re. m.z~ No. /OMe ~ cz'~ ' . ~~_~ ks comDZe~eo and ~ - ,c.~ znspe~t~on ~s ~fas ~oeen done. In order to com~e ~h~s file, it is necessary ~t a Certificate of Oz~pancy be issued. Please f~ll out the enclosed ~heck for ~5 00)' re~urn same to the above office w~h a · ne~cate t~payabte to ~he Town of Southold. Please the C~rtifacate of Ocz~pancy ~s to be ~aiZed~ ~nd arrange wxth this off~ce for an inspecEion date. Thank you for your prompt attention. Very truly yours, Victor Lessard Adminis~r~ tor VL:ec EnClosures EC)~M NO. 6 TOWN OF SOUTHOLD [~uild[ng Depar~mem: Town Hail Southold, N.Y. 11971 APPLICATION FOR CaRTIFiCATE OF OCCUPANCY instructions ~ n,: ¢22I'cat~cn must be filled in typewriter OR ~nk, and submitted ~n dupHcste to the Building Inspec- tor '.v~m ;;'3 fat!o'.ring; for new buildings or new use: 1. F'.2c~ sur:ay of property with accurs~e location of all buildings, property lines, streets, and unu~al 2. Fmj~ ,'asrovz~ of Heaitn Dear. of wa~er suDo~¢ and se,.vera~e dispose --IS.Q form or equal). 2..~r;2~c..2~ o~ e!ectr~ce( (nst~ll~t~on from Baaed of F re Under. rite.s. 4, Commerc~:l bu~Idlngs, Industrial buildmes, Multiple ResMencss and similar buildings and instaHa- t~ocs, a c~rdflcate of Code compliance f~om the Arch[toot or Engineer resuons.ble tar the buddM~. , ,~n,,ing .o~rd approval at camp clad s~ta o an requirements ,,,/here applicable. For exlstln~ buddinos (prior to Aprd 1~3/), Non-conforming uses, or buildmcs and" ~ ~ ' ' ' lane u:es ~ pre-existing 1. Accurate [~p/ey of peoper~y sh'owmg all property lines, ~reets, buildings and unusual natural or 2. ~v. orn statement of owner or previous owner as to use, oc~ggancy and condition of buildings. ~. Da~e of ~n,,, housing code or safety ;ospect~on of bu¢ld~ncs or premises, or ~,~erpertmentmforma. Fees' 1. C.'rt,~f.ca~ of occuaancy S5.00 2. C.'r:~f,ca'- of occupancy on pre-ex~stmg dwelhng or land use 3. Cc2,,, of cert~flcete of occupancy SI.CO N~.v :'uud,¢z .' · . Old or Pre-existing Sullding(Z) - ' ' . ....... _- /Vacent Land ......... Ccun:,/Tax :,.1¢~ No. 1000 S¢¢*[on ................. Block ............. ................................ Filed Map No ........... Lot No. /. t ............. Heahh O .... Approval ........................ Labor Dept. Approval ......... ........................ Planning Board Approval .................. R.~.est for Temporary CertifiCate ..................... Final Certificate - Cc~s[ruc::on on above descrd)ed building and per't[ meets all ~op~[F~bl~od3sanc regulations. Apphcant ¢ ~ , FCF,*,1 NO, 6 TO'.V,~¼ OF SOUTHOLD ~u i~c'in9 Department $outhold, N.Y. 1197: APPLICAT~OFJ FOR CERTIFICATE OF OCCUPANCY Instructions ......... ~n must be filled ~n ~ tor,.'/~;n t,*3 foHo'.vmg; for new buildings or new use: uphc~, to the Buildin~ t ...... 1. F'na~ :ur:e,/ of property with accurate location o~ all buddings, property lines, streets, and unu~: ~ ~ .... ~r=~ dLw~s~l--(S-~ form or equal). ~. ¢,c~:c,?1 o[ e!ec~ncat m. ~1/~ ,on from Sosrd of =' ~ 4. Ccmmerc~:I buildings, Industrial buddings, Multmle Residences and simiiar bui[dlngs ~nd t~e~. a car~flca~e of Code compJience from the Architect or Engineer remons,~ie for the buli~ic~. 5 Sucm~ P~cnm~g ~oard approval of ccmp~eced s~te plan requ~reme~t: where appiicsble. - For existm3 build[ags (pr;or to Aprd 1957), Non-conforming us~s, or bu]Mmgs and "pre-ex~stmg" ~. Accuray/ sun/e,~ of peoperty showing atl property lines, %reefs, buildings and unusual natural or ........ ,.m~nt of owner or pre'.qous owner as to use, cccug~nc,/ ~nd condition of buiMM~s. 3. D~(e of :n,,, housing code or safety mspec:~on of bu,[dinqs or premises, or omar pertinent mforma- $5 O0 C. Fees o~ua.n~.y $5.00 2. C~r:,Lca:~ of occuD~ncv on pra-ex~stmq d',v~lline nr land usa 3 Cc~', .... z- ~.= - ~ ~ .... · o, c~ .h c~ or occugancv SI.CO ..... ~' · Old or Pre-existing ....... ,~u cL.v,..) ........ : /Vacan~ Land ............ CcumvTax :A~o No 1000Section ' ............. ................. ................................. Fded MaD No ........... Lot No .............. HesRh Dc~:. Approval ........................ Labor Dept. Approval .............. , ........ ,.. Urd¢~.'~r,te.: Approval ........................ P]~nmna Board Approval ,~r Temporary C~rt,,,c.,e ..................... Final Cartihcate ~ . Con:[ruc:.on on above d~-~r,o~d building and permt[ meats all .,,~r .~ ~,~,~c~'3le:~.odas and regulations. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Disapproved, c ........................ (Buildffng Inspector) APPLICATION FOR BUILDING PERMIT Application No. f~.~.~. ~ ....... INSTRUCTIONS a. This application 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 f~ving 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 issue 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 fo~ 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 buildings for necessary inspections. · ........ (Signature of applicant, or name, if a corporation) · ~ ~v0 0,'/..l)glg .~...~1~..T.0. O..e--. .. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ................................................................................. Name of owner of pre~nises .~. ·. ~ ~. ~r.~-~..~k~l.~. ~ ............................................ (as on the tax roll or latest deed) If apphqtant is~ cprporation, signature of duly authorized officer. ~ / (Name and t~tle of co~orate officer) mBl~ilmO2~'rS, skiL]]en~]e;°~'' ~[ ~: ' ' ~ ~ Other Trade's License No ...................... 1. Location of land on wtuch proposed work will be done ................................................. ........................ o... ............ .'x'..u.c4 .< .................. House Number Street Hamlet County Tax Map No. 1000 Section .../../.~- .......... Block ....(~.'~, ........... Lot Subdivision .................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occtlpancy of Proposed construction: a. Existing use and occupancy . [ IO.O ~ .~."[~4..~,~-, ....... ~ .D~.t.ko.~.,.,..%..~¥g~. .................... b. Intended use and occupancy ~ *'~ ~.~9, .~.~.. V~.~.. ~? 4. Nature'of work (check which applicable): New Building .......... Addition ........ Alteration Repair .............. Removal ........ Estimated Cost ' .... Demolition .............. Other Work ............... (Des~r,ipti°n) ............ ........................ (to be paid on filing this application) 5. If dwelling, number of dwelling units, .;..)/~ ........ Number of dwelling units on each floor ................ If garage, nnmber of ' cars ....... ............................................. :, ................... 6. If business, commercial or mixed ~ccupancy, specify ~gtk~re and extent of eac~l?e of use ~g.td.~. ~.,*~~f~ C~ ........ 7. Dimensions of,e.~istingz~, structures, jf any: Front .... / .......... Rear .............. Depth 2 ........... Height ............... Numb0r of Stories ............... ~¢~//~. ' · ' ' s or~i~i Front Rea Dimensions of~a/m~e structure w~th alteration ons: ................. r .................. Depth... ................... ~. Height ........ ~'9 ........... SumCe{/of Stories .......... · ' ' ' pth 8. Dimensions o/foent~re new construqtmn: Front ....... ,...! ..... Rear ............... De ............... · ~N, L~uj~,kr of St ' I .,,Po Height ....... ...................................................... ones · , o- · · 9. Sizeoflot: Front ...... Z)~<'~O ' .......... Rear ...................... ~?th, ~o~t..4r~l .......... 10. Date of Purchase ..................... .~ Nameol~ICormerl~vner 11. Zone or use district in which premises are situated.. ,%~. 7..'.. 7 ....... ~ ..... ,~O ......................... 12. Does proposed construction vjoJo,te any zoning law, ordinance or regulation: ............................. 13. Will lot be regraded ...... ~"~'~' ~'b", ~:-*, '.' ~ Ol'-~ ....... Will excxss filLhe r~moved from premises: ~ 14. Name of Owner of premtses~.... 1 ................ ~ddress ................... rnone mo ................ Name of' Architect ...~ .......... ,p,, ..~.~ ......... Address . .~q,.,~r,~,.,. m ..... Phone No...~.,,- ........... iName o~ contractor .......... . ................ ^aaress ................... tmone ,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 nhmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~RK~~ , ,..d' ~., COUNTY OF~..~':~ .": ./?.~..~.%~77~', ~'~ ' .......... ./ .... F/. .................. ~ ............. berne duly sworn, deposes and says ~at ~e ~s ~[~ applicant 6~me of(ndividual signing contract) above named· ................... ' ........ He is the ................. ~f' ' ~ .... ~ontractor, agent, corporate officer, etc.) of said owner or owners, ~d is du~y authorized to perform or have perfomed the said work.~and to m~e ~d ~e this application; that ~1 statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~nCr set forth in the application filed therewith. ~" Sworn to befo~ me this ~OTARY PUBLIC, State' of N~ Ym~ ~ ' No. B2.S12585B, Suffolk' OIl~ t~(n ,[l~Dlrelt March (Signature of applicant) Page ~, September ~'Y L . ? / '1