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Home My WebLink About11393-zFORM NO. 4, TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certi[icate O[ Occupancy No. Z10.917 · Date March 22 . ... ....... 198.'.2 THIS CERTIFIES that the building ................................................ Location of Property 1275 Bungalo~ Lane Mattituck House IVo. Street Ham/et County Tax Map No. 1000 Section 123 .Block 07 .Lot 017 Subdivision Mam'agooka Park .Filed Map No. 19 .Lot No. 13 conforms substantially to the Application for Building Permit heretofore fried in this office dated September 11 19.8.1. pursuant to which Building Pen. nitlqo. 11393 Z dated . . . .S.e.p.t. ~.m.b.~...2.8 ....... /.... 19 .8.1. , 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 ......... a deck addition to an existing dwelling. The certificate is issued to Eugene G. & Ellen M, Steigerwald (owner,"'l,~ ol"t~tmtl~ of the aforesaid building. Suffolk County Department of Health Approval .... n../?. .................................. UNDERWRITERS CERTIFICATE NO. n/v Building Inspector Rev. 1/81 COMPLETION OF THE WORK AUTHOR ZED) Per~niSs o6 )s hereby 9ranted ..... .... ~(.~.:.',...4~ :~.....Z&~...~...,~ ................ ....... ~,. :..~.~ ........ ........ ~: : , .~//~=. . , - . .. :~... ..... ~ ~ ................. ~o, ,..;:..~.cZ ........ ~and,approved by the Bu!l¢ing h~spector. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subn~itted in duplicate 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 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 survey of peoperty 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 required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New B"~!dh~g ..... Old or Pre-existing Building(Z) ;. _ .... ~/Vacant Land .......... House No. ~"treet Ham/et Owner or Owners of Property ...~'..~-~. ~.. f~ ..... L?.~..~'~. ~' .~7'. ~...T.~-t ~)=~.~p..~.L~,.~ .......... County Tax Map No. 1000 Section .. ~-, .~ ........ Block .... ¢~ .-]. ....... Lot..(~3 .'7. .......... Subdivision .... ,~,, ,~f~, TPP,. ,~,,,, ,[-~ ,~,. ...... Filed Map No, . ,t;~ ...... Lot No. ~,~,,,/~,, , , Permit No, ,[~'~,~ .... Date of Permit .~,/~ ~[{,, ,Applicant , ,~,,.~ ~.~:~v'~, ,~,,,, Health Dept. Approval ...... ~//.1~.., ........... Labor Dept. Approval ... ~././~... ............ ,.. .~.~... ' Plan i Boa d App al Underwriters Approval ................. n ng r roy ........... Request for Temporary Certificate ..................... Final Certificate ~ ...... - ......... Fee ~ubmitted $ .... ~. .............. Rev. 10-10-78 ...~. -~.. ,?..-Y-~_...~,.~_..-, .., ~ ~ ,. .... , . Construction on above described building and permit meets all app~i,cable_.codes and regulations· Oc; 2G, FIELD ~NS?ECT£ON FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL DATE COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.; 765-1802 ^pprove . .... Disapproved a/c ....... : ............................. './ . (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No.././.~..~. ...... INSTRUCTIONS a. This application must be completely filled in 'by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according te schedule. b. Plot plan showing location of lot and of buildings on premises, r~Iationsh[p to adjoining premises or public stret or a~eas, and givh~g a detailed description of layout of property must be drawn on the diagram which is part of this apl cation. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon apprcval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern shall be kept on the premises available for inspection throughout the work. e. No buikt/ng sbalI be occupied or used in whole or in pa~ for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. ~PLICATiON 1S IIEREBY MADE to the Building Department for the issuance of a Building Pe~it pursuant to t BnildJng Zone Ordinance of the Town of Soutbold, Snffolk County, New York, and other applicable Laws, Ordinances Rcgnlations, fro' the construction of buildings, additions or alterations, or for removal or demolition, as herein describe ~The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, ~d ad u t authorized ~spectors on pre n scs and m buddings for necessa~ inspections. .......... (Signature of applicant, ~r name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee,, agent, architect, engiueer, general contractor, electrician, plumber or build, ..... O. ~r0.~.: ................................................ : ............................... ~..ne of owner of premises . .~.u. ¢..~.e...~...{, .~..c.?_.. ,~.,, .tKX,..~.T~,. ,er..e'ff..~.~,~ ........................ (as on the tax roll or latest deed) If applicant is a corporation, ~mture of duly authorized officer. (Name and title of corporate officer) Bt rider s L cense No ..................... Plumber's License No ......................... Electrician's License No ....................... Other Trad'e's License No ...................... 1. LocatiOn ofland on which proposed work will be done ............................. ........ ..... ........ ......... House Nmnber Street Hamlet County Tax Map No. 1000 Section ...l.~ ......... Block . ~.~ ............. LetO. ~ ~ ........... Subdivision... ~ ~ Filed MapNo..A~ Lot (Name) 2. State existing use and occupancy of premises and inteuded use and occupancy of proposed construction: Existing use and occupancy I ~.~ l ~[~.%~. b. Intended use and occupancy.....[ ~.,.~.~. ~ ,~ I. Nature of work (check whicl, applicable): New Building .......... Addition..'~.: ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~/~ ~'~)O ~ i5,~_~~ (Description) Estimated Cost ...................................... Fee .......................... ¢ ........... (to be paid on filing this application) ;. If dwelling, number of dwelling units...~. ~?..~.hal~ ..... Nmnber o f dwelling units on each floor.. ~ ........... If garage, number of cars ... J[ {.l'~. ~:1~#~1~. ................................................ i. If business, commercial or m/xed occupancy, specify nature and extent of each type of use ............... t. Dimensions of existing structures, if any: Front ..... ~. ........ Rear .............. Depth. ~ ..... lteight ............... Num her of Stories ..... O~...~ .................................. Dimensions of same structure with alterations or additions: Front ....... .~ ........ Rear ..... Depth ...................... Height ...................... Number of Stories ......... Dimensions of entire new construction: Front ............... Rear ............... Depth .. Height ............... Number of Stories ....................... . .................... ~. Size ofl~t: Front ..... ~ .............. Rear ............... · ....... Depth . ~,~ .... I. Zone or use district in which premises are situated .................................. ?. ........... 2. Does proposed construction violate any zoning law, ordinance or regula:ion: ........ ~ ................. 1. Will lot be regraded ....... ~19 ................... Will excess fill be removed from premises: Yes Name of Owner of premises ~. ~..~ddress ~}.~-.ffi.~. Phone No. ~ ~ ~ ..... Name of Architect ........................ ;.. Address ................... Phone No ................ Name of Contractor .... ~.~ ............... Address . .. ~x.. ......... Phone No ............... PLOT DIAG R~MM Locate clearly and distinctly ~1 buildings, whether existing or proposed, and.indicate ~1 set-back d~emions from roperty ~nes. Give street and block number or descfiplion according to deed, and show street names and indicate whether .tefior or corner lot. ou,x~rY OF .... ~.~;~ : . . S.S ...... g ............. (Name of indMdual signing contract) >eve named, being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) t' said owner or owners, mid is dtd¥ authorized to perform or have performed the said work and to make and file this .>plication; that all statements contained in this application are true to the best of bis knowledge and belief; and that the 'ork will be performed in the manner set forth hi the application filed therewith. worn to before me this · / a of ?./ ............' · 19 (Signature of applicant) · ' ':¥' Ten~ '£~lr# Ma~:t~'