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Home My WebLink About11244-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of OccuPancy Z10787. Date November 20 1981 THIS CERTIFIES that the building ................................................ 865 Love Lane, Mattituck, Nevi York Location of Proper House No. Street Hamlet County Tax Map No. 1000 Section . .1.4. 1. ....... Block .... q3. ......... Lot .... q2..6 .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8t 1124/~ .Z. May 28 19... pursuant to which Building Permit No. July 2 81 dated ............................ 19 ....was issned, and conforms to all of the requirements of the applicable provisions of the law. The occupancy ~r wMch tMs ce~ificate is issued is ......... ~ccessory Storage Bui~din~ The certificate is issued to . . .J.a.m..e.s..6.'9 9 p.e.r. .......................................... (o~e~ ~o~ l~at~x x x xx of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS,CERTIFICATE NO.~/..R .............................................. Building Inspector Sou H'O : (THIS PERMIT MUST BE KEPT ( · COMPLETIOh OF THE WORK AUTHC~ ZED) Pe~r~ission is hereby granted FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted 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 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. 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 lin~s, 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. Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building.............× Old or Pre-existing Building ............ Vacant Land ............. Location of Property . 865 [,ove f.ane~. Hat, t.i~uck! New ¥or.k House No. Street Ham/et Owner or Owners of Property ............................................................ 141 03 026 County Tax Map No. ~000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. 11244Z 7¢2/81 Permit No ........... Date of Permit ......... Applicant .................................. H alth Dept. Approval ........................ Labor Dept. Approval ~.)'!e .................. "_ Underwriters Approval ........................ Planning Board Approval ................ Request for Temporary Cert f cate Fin*l ~rtifi~2f~ ....................................................... ~.- Fee Subm tted $ 5.00 .............................. Constructmn on above described building and permit meets all applicable codes and regulations.' FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY Q,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To . .J.~. ~..~: .v.. ~__C~.~. ~: ......... ..... . ........... ! PLEASE TAKE NOTICE that your application dated ..... .~/.(7~.~ .~. rS' . ...... 19 .. ]~?.. for permit to construct .... ~ .~.. x~. ~. F~/././. ~q~....~.~....~. F./:~,//~- .~ .~!~? :'~ at Location of Property :~.....~,.cJ.~..~.~../<?. ......... ~ .......... .~...~,~//..~.c. .ouse ivo. ~/ ~/- // Street r~amter County Tax Map No. 1000 Section .... '..- ........ ~lock ..d~. ~.. ....... Lot .. ~. 2~ ...... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds ...~X,~.~G'~ ..~.~-./. ..... .5. ~.~,~....~.~.~....~..~..~.~...~ ....... ~...~..7~.. ....... /. ~.o...~..y/.'. .... ~ ~ c.~.. ~..-.~ ~.. ~. ~....~.~.~<~.~.?: ...~.~.~.. · ..... Building Inspector RV 1/80 FORM NO. 1 TOWN OF SOUTH0LD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-1803 Disapproved a/c ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public strer or areas, and giving a detailed descriptiou 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 Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such peru shall be kepi 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 Occupan shall have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department ifor the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, .Near York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances admit authorized inspectors on premises and in buildings for necessa~ building code, housing code, and regulations, and inspections. dgnature of applicant, or name/if/~ c_orporation) ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ ................... .......... ................ ....................... Name of owner of premises..~.3~..(~.~~.. ~'~ ........................ If applicant is a corporation, si~ afure of duly authori~d o(;;~ the tax roll or ~titest deed) (Name and title of corporate officer) Builder's License No ...... ~ ........... Plumber's License No .......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on, which proposed work will be done, ~ ~, .~,. ,0(~: ,~ .~:~ .......................... ............ House Number Street County Tax Map No[ 1000 Section .... .~. .........:.. Block .................. Lot ................. Subdivision ................................... 1. · · Filed MapNo ............... Lot .............. (Name) State existing use and occupancy of premises ~,nd intended use and occupancy o£ prol~osed construction: b. Intended use and occupancy Nature of work (check which applicable): New Building . . .2~?.-- v' .' Adaition .......... A~c~ratio, .......... Repair Removal Demolition Other Work Estid ............ mate Cost ............. ! .................... Fee '. ............ ~ ........ , (to be paid on filing this application) If dwelling, number of dwelling dnits ............... Number of dwelling units on each floor If garage number of cars ' If business, commercial or mixed occupancy, specify fi0ture and extent of each type of use ..................... Dimensions of existing strncture~, if any: Front ..... : ......... Rear .............. Depth ............... Height ............... Number of Stories ................... ..................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... !. Height ...................... Number of Stories ...................... Dimensions of entire new constrimtion: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front : Rear Depth ................. Date 6f Purchase ........... ! .................. Name of Former Owner .......... ~ .................. Zone or use district in which preinises are situated Does propose'd-~nstruction violate any zoning law, ordinance or regulation: ................................ Will lot,be regraded ...... .1. · ' ....... ~ ........... Will excess fill be r0moved from~.Lemises: · Yes No Name of Architect ....... .~ ............. # ..... Address ................... Phone No ................ Name of Contractor ....~-r~'~cv~_~v~. .......... Address r~ ...... Phone No./fq--~-~-¢~ ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from roperty lines. Give street and block humber or description according to dee~ and show street names and indicate whother ~tenor or corner lot ' .~ ~,~-,f ~ iPr~ rATE OF NE;~ YQ,F,~, , /_. 'S S .... ...~. ~. ~ .................. being duly sworn, deposes and says that he is the applicant 7]" "ihinTe ;'f individ¢l signing contract) )ove hamed, i Deis the ........ : ....... ~l.4.~c{w-x~_~,_~. ............................................................ , (Contractor, agent, corporate officer, etc.) f said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this >plication; that all statements cont'ained in this application are true to tbe best of his knowledge and belief.¢ and that the 'ork will be performed in the manner set forth in the application filed tberewith. worn to before me this .... day of ~. ~. County qOTARY pUBLIC, State of New .~'"""'-~':)~'~"~--~' ~.-'~':'-~ ..... // .......... FORM NO. 1 TOWN OF SOUTHOLD . BUILDING DEPARTMENT TOWN HALL · SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ................ , 19... Approved ................ , 19... Permit No ............ Disapproved a/c ..................................... Application No ................ (Building Inspector) /~PvL~CATiOlq I-0,.~ BUiLDiNG PERMIT 19. INSTRUCTIONS a. This application must be completely filled'Sn 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 to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre~ or areas, and giving 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 Permit. d. Ui~on approval 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 building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildhrg Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, ~lew York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations or .for removal or demolition, as herein describ~ The applicant agrees/to comply with all applicable laws, ordinances, ~ .filding cod[,, housing c,~de, and regulations, and admit author/zed in~ectors on premises and in buildingslr necessary/~ lspections.~ ______/~J-. '/ / 'l] fff~ .,~ [y.,~ (~jJgnatg,re of app,~icant, orname~ifacorpora ' ) II, V ' -.~,~,j, gl ~j (Mailin~ address of applicant) State whether applicant is owner, lesse~, agent, architect, engineer, general contractor, electrician, plumber or build, .............................. ~1,~... ~..~-<..T. ................................................ of owner of premises .... eX. · · ................................ (as on th0ttax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ . . ............... .l,.L. . .a. .......... . . .*. /.< , .'. .V, House Number Street Hamlet County Tax Map No., 000 Section ....... ~/ ..... Block ... ~..~ ......... Lot..~. ....... Subdivision... C~a ' Filed MaP No. Lot ~. (Name) 2. State existing use and occupancy of premises and intended use and occhpancy of proposed construction: a. ~xistin~use an~ occupancx ........ ¢~'.. .'~Z;{( ....... ~t'.. :~:{~... {t~ . ...... .. r: ~ · · ' ............... b. intended use and occupancy . ~-c~ ~~ ~ ~ ,~ X .. /, ...... Alteration ........ Nature of work (check which applicable): New Building . ~ ...... Addition .,. . Estimated Cost. · · ,.. ....... .,~F...'?( ...... Fee ....... (to be paid on filing this application) If dwelling, number of dwelling ~nits, ............... Nmnber of dwelling units on each floor .............. If garage,,, number of cars ..... ~ .............................................. i ............... If business, commercial or mLxed: occupancy, specify nature and extent of each type of use ................ Dimensions of existing structures if any: Front ............... Rear .............. Depth ........... Height ............... Number, of Stories ................................................... Dimensions of same structure wi~h alterations or additions: Front ................ Rear .............. Height Number of Stories Depth .................... ~ .......................................... Dimensions of. entire new construction: Front .............. Rear ............... Depth ............ Height Number of Stories ' Size o£1ot: Front ........... i ........... Rear ...................... Depth .................... Date of Purchase Name of Former Owner Zone or use d~_str, ct in which pretn.ses are ~t..*ed Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ........ .......... ~ ........ Will ex~ess fill be removed from premises: Yes . No Nmne of Architect .......... ~.'~' ~ .~.~ ................ AddreSSAdd ................... p1Ph°ne NoN° ......... ,~ 0., .'~ i~ .... ' Nml~e of Contractor .... - ...... -~ .... ..tess ................... ~one ....... Locate ,clearly and distinctly all :operty lines. Give street and block ~terior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all set-back dimensions from mmber or description according to deed, and show street names and indicate whether TATE OF NEWQ~K, .5>..~:~M-~ .... ..~~ ............. being duly sworn, deposes and says ttff~3ne ia the applicant ~" (Name of individual signihg contract) Dove named. 5eisthe ..................... (Contractor, agent, corporate officer, etc.) f saki owner or owners, and is duly authorized to perform or have performed the sa. id work and to make and file this pplication; that all statements cont¢ined in this application are true to thh best of his kmowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this