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Home My WebLink About11248-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16955 Date June 3, 1988 THIS CERTIFIES that the building ACCESSORY Location of Property 100 Park Ave Mattituck, N.Y. House No. Street Ham/et County Tax Map No. 1000 Section 123 .Block . .7. ............ Lot 5.3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 29, 1981 pursuant to wh/ch Building Permit No. 11248 Z dated ..... J.u..1 .y..6' ~...I.9.8. ! ......... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wlfich this certificate is issued is AC'CESSORY STORAGE SHED Tile certificate is issued to THOMAS & PATRIC IA CAREY ..................... ?o¥.'~;,'l~a~/t~k .................... of the aforesaid building. Suffolk County Department of Health Approval .......... .N./.4 ............................ UNDERWRITERS CERTIFICATE NO .................. N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 ToWN SOUTHOIJD, FL ¥~ BUILDING !FERMIT (THIS PERMIT MUST BE, KEPT ON ,TFI,E pREM, COMPL£TION OE TBE ~ORK AUTHORIZED) 11248 Z Permission is hereby granted to: and ~pproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - [802 APPLICATION FOR CERTIFICATE OF OCCUPAI% Instructions TOWN OF SOUTHOLD 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 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 requWements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,$25.(10, ~.c..~?S~sory,,~$~Q.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50 00 3. Copy of certificate of occupancy $ 5 00, over ~ 7ears $]0.00 o.o. ,o.oo - 5oUpdated C.C. $ 50.00 Date ............... New C OhS tr uc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ../.~..~. ............ '...~..~..~ ................ .~..~.~.'.Z~..~.~.. .................. Owner or Owners of Property . .'~..~, .~.d.~. ............ County Tax Map No. 1000 Section ..... /.~.~ ..... Block .... .C~.~. ....... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. J/.~..~.F.o Date of Permit Health Dept. Approval ........................ Labor Dept. ADproval ..................... ;.. Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. /'~ Construction on above described building an meets able codes and regulations. Apphcant .., Rev. 10-10-78 · ~ FIELD INSPECTION 1. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL COMMENTS ADDITIONAL COMMENTS: Examined .~ °/ , 19O~ 'sapproved ....... : ........ .................. / ~i,, (Building Inspector) APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-1803 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 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 descriptiou of layout of property must be drawn on the diagram which is part of this apg 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 'isstie a Building Permit to the applicant. Such peru 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 Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, ~>r for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, :building code,~using code, and regulations, and admit authorized inspectors on premises and in buildings for necessa~o~ ~_ (S,~gnatpre of applican,t~', or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Name of owner of prmnises ...'~../~.. fi~S.~..5'...~. ................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Nmne and title of corporate officer) Builder's License No. ~::i:.~.9/_~/~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ House Number Street Hamlet County Tax Map No. 10~0 Section ...~ gJ .......... ~o~k ..... T ........... not ............... ~ _~gu~4iaq~tlSn Filed MapNo Lot (Name) 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 . ~...~.~? F~' e~4~,/.A.~ ..~...<~. · .~.~..~. ~-~7'~/~-~:~ .~..~...,.~.~. · Nature Of work (check which applicable): New Building .......... Addition .......... Alteration Repair .............. RemoVal .............. Demolition .............. Other Work.. ,>~ ........... ,/-.~'5'~ ~'2",'q,~'~/'~¢ /-~'°~°° .~ro~Ac,~ ,q~'~rl> (~ ~/~ ~& ~ (Description) Estimated Cost ............................................... ~'. .......... (to be paid on filing this application) If dwelling, nmnber of dwelling finits ............. 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 .................... .... ,. ~ ~ D~mensmns of ex~st~ng structure0, ~f any: Front. ~ ~ .......... Rear ... 9 .......... Depth .......... Height ~.~ .......... NumCer of Stories .... ~ .................................................. Dimensions of same structure wi~h alterations or additions: Front ................. Rear ................. Depth ~ Height Number of Stories Dimensions of entire new construction: Front ... Z * ~ Rear l.~ ~ Depth .~. Height ~ / ...... Number or Stories . ~. ....................................... · ..... ~ ..... , · . Size oqlot: bront : ~ ~ Rear ..... ~.~ ............. Depth .- Date 6f Purchase Name of Fomer Owner .... in which premises are situated Zone or use d~stnct . .................................................. Does proposed .... ordinance or regulation: constructmn wo~te any zomng law ............................... Will lot be regraded...........................~' . Will excess filt be removed from premises: Yes No Name of Owner of premises ..................... Address ................... Phone No ................ Name of Architect .......... ] ................. Address ................... Phone No ................ Nme of Contractor ...O.~ ............. Addres~~ ...... Phone So..~ :.~2~.. PLOT DIAGRAM Locate clearly and distinctly all lbuildings whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or corner lot. rATE OF NEW 7~t).Rj~/. , Z is s ..... ~...C~..'..~. ;--. ....... being duly sworn, deposes and says that he is the applicant (Name of individual sig~i~ cont~t) )eve named. is the (Contractor, agent, corporate officer, etc.) f said owner or ownS, ~d is duly authorized to perform or have performed the said work and to m~e and file tiffs ~plication; that ail statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed.in the m~n ~r set forth ~ the application filed therewith. ~om to b~fore me thisff . ........ ..... ....... .... otary Public ~~A.~~~> Coun,[ Nota~ Public, ~ath of New Yo~ Commission Expi're~Mar~h 80, 19~