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Home My WebLink About10861-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z- ] 6348 Date October 28, ]987 THIS CER!qFIES that the bmlding UTILITY BUILDING cI ""o)e' 2505 Bray Ave. & 240 Wells Rd. Mattituck, New York Lo'at,on o, rr t rty ............................................................. Housa No Street Hamlet County"Fax Map No. 1000 Sechon . .1.2.6. ...... Block 9 .Lot 9 Sub(hvision ........................... Filed Map No ......... Lot No .............. conforms substantially to the Apphcation for Building Permit heretofore filed in this office dated September 19, 1980 pursuant to which Building Permit No, 10861 z dated ... ~e.p.te. mb..e.r..{.9:..1.9..8.0., wasissued, and conforms to all of the recluirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... UTILITY BUILDING The certificate is issued to ARTHUR & LORRAINE STELLMANN ................ .................... of the aforesaid building. Suftblk County Department of llealth Approval ....... N/A UNDERWRITERS CERTIFICATE NO .............. N/A PLUMBERS CERTI] ICAqlON DATED: Building Inspector Rev. 1/81 FORM NO. ~ TOWN O~: SOU'm~i BulLDINe TOWN HALL SOUTH~OLD, N~ Y.'~ BUILDING FE P,~Mr (THIS PERMIT MUST BE KEPT ON THE PRE COMPLETION OF THE WORK AUTHORIZED) N? 108~1 ~Z tI~ES UNTIL FULL Building Inspector. ......... Permission is hereby granted to: P. O. ~X~ ~ - .......... : ............................. : ....... :'"'T'"? ................ ?' ct premises iocatea at ...................................................... ;.-? .......... ....................................... Coun~ Tax Mop Nc. !O00 Secf~on ................. ~..... 8]ock;.,.~i ................ ; kot No ......................... .,cp~aO, 9 ;, 19...~, and approved by the pUauant to application dated .................................................. ~ ....... , 'Inspector FORM NO. 6 TOWN OF $OUTHOLD 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 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 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 pz~operty 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 requ ired to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$I0.00 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 5. updated ~Q.~ $ 50.00 Date .... ~... . NewConstruc%ion ...... Old or Pre-existing Building ............ Vacant Land ............. Locat,on of ...... ...... ....... .... 7 ......... .... .......... Subdwision ................................. ~iled ~a~ ~o ........... Eot ~o .............. Health De~t Unde~Hters A~roval ~ ~lann~n~ 8oard A~¢roval ....... Bequest for Temporarg Certificate ..................... Final Certificato ..... ~ .......... ~ee Submittod $ .... ~ .~. ..................... Construction on above described building and permit meets all.applicable codes and regulations. Applicant..~..~,..~ ...... Rev. 10-10-78 ¢0 '~ 163q~/ :1 'I/,M '/¢/¢~' Al:) 13 IT'ION/AL_ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined (~/{o~, 19 /~'-f)' TEL.: 7fi5-180:3 Approved ........ :? (.'Ct., 19..~.~erm~t No./.~. ~..~l. ·Z~. Disapproved a/c .... ~7--....~.L~~ .................. ..................................... (Bmldmg Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This apphcation must be completely filled in by typewriter or ~n ~nk and submitted in triplicate to the Building Inspector, with 3 sets or plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocation of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detmled description of layout of property must be drawn on tile diagram which is part of this appli- cation. c. The work covered by th~s applicatmn may not be commenced before issuance of Building Permit. ~. d. Upon approval of this application, the Bnilding Inspector will ~ssue 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 occupmd 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 Sonthold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construction of buildings, addihons or atteratmns, or for removal or demolition, as herein described. The apphcant agrees to comply with ali apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspec?rs on premises and in buildings for necessary insp,ection, s ~________________.~_~ (S~gnature of applicant, or name, if a corporation) .,. . .,. .. .-->. r.,. .z z ;/ .............. (Mailing address of applicant) State whethm appbcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . , (Name and title of corporate officer) Bmlder's L~cense No ........ ~.ff ~-..~. ......... Plumber's License No ....................... Electrician's License No ...................... Other Trade's Liceuse No ...................... 1. Location of land on which proposed work will be done ........... ' ...................................... .. C: . . x: ., t. v. .,. . &. : ........... L . ....../. r. /.c ..................... House Number Street Hamlet County Tax Map No. 1000 Section ................. 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 ...C.~./.~/[[.,~.. ~.~/v~ /~*~. ~ b. Intended use and occupancy ..... .~.,/d./~.,'2' .... .~.~./.~.z?4~.;..r../.o.?. ~...~J/'/~~~ 3~ Nat0re of work (check which a~plicable): New Building ......... Addition ........ Alteration .......... Repair .............. Remgva1 .............. Demolition .............. Other Work ............... 4. Estimated Cost ~ .~. ~ ~ I ~ , (to be paiff on filing this application) 5. If dwelling, number of dwelling 'units ............... Number of dwelling units on each floor ................ If garage number of cars ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing stmctt r~s if any. Front ~-~ ~a~ ~d-~ : Height g.(-.q .......... Number of Stories .. 2 .............................................. D~ensions of same structure with alterations or additions: Front Rear Depth ...................... HeiSt ...................... Number of Stories..2 .................. 8. Dimensions of entire new const~ction: Front ............... Rear ............... Depth .............. Height Number of Stodes 9. Size of lot: Front . .~g.&x~.: ........... Rear ../.~-~ r. ~ ........... Depth . .~G. 7.~ ............ 10. Date of Purchase ............................. Nam~ ~om~Owner ............................ 11. Zone or use district in which premises are situated ...... ~).../~t~'~ ............... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded . .~...~. ................... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises ................. Address ................... Phone No ................ Name of Architect . Address Phone No Nme of Contractor " Address Phone No PLOT DIAG~M Locate clearly and distinctly ~1~ bufld~gs, whether existing or proposed, ~d. 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~,~YQR, K,, '¢ . $.S COUNTY OF..o.ff ? P.4.Z :... .... .... ...... ....... (Name of individual signing contract) 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 perfoxmed the said work and to make and file this application; that all statements contained in this application are true ~o 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 c-p 7-A~ ............ /...-~ ....... day of Notary Pubhc, Quahhed in Suflolk County ~ ~/ ' ' '~ - .................... Commission Expires March 30, 198~ (Signature of applicant)