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Home My WebLink About11089-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No Z12238 Date FEBRUARY 2 84 THIS CERTIFIES that the building 2~CCESSORY Location of Property 1015 FACTORY AVE. MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section .... ],22 ..... Block ..... 2 ......... Lot ...... 2,[ ..... ;. ~ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated · ~.~I~I..27 ........... 1981. pursuant to which Building Permit No .... 110897.. ........... dated .. AP. RI~,. .6 ................. 1981., 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 ......... FOR AN ACCESSORY GARAGE The certificate isissued to ,ROBERT H~ JONES & WIFE LORETTA (owner, le~see or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....bl/.3~ ................................... UNDERWRITERS CERTIFICATE NO ................................................. Building Inspector Rev. 1/81 FORM ~0o 9 TOWN OF SOUTHOLD BUILDING DEPART/vlENT TOWN HALL $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 11o89 Z Permission is hereby granted to: ....... ~ .~z..~Z......~-~-~..(...~. , .... ~.,.~.~.......~..x.....~.~ .............. z~ z ,~:....,.,.x~-'Z.~z~.~..%.... Zz, X,~%.~-.,., .~', ,o ...... .~..~.~.~..~z:.....~=.~ ~.~.~.....~.~.~.?~.. ........................................ ~, premises located at County Tax Map No. 1000 Section .... .~.,~:~. ....... Block .... ~.~. ......... Lot No. ~/~/~., ............ pursuont to application doted ...,~:?.~.......'.~....~'.. ............. , 19~..d.'., and approved by the Building Inspector. Fee $..,/.~.......'~.. ...... Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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 features. 2. Final approval of Health Dept. of water supply and sewerage disposel-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercia~ buildings, Industria~ buildings, Multiple Residences and similar buitdings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Su bm it P lan nih g Board approval of comp leted site p lan 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 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. Fees: I. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $ 1.00 --Pre-Existing C.0. $15.00 Vacant land C.O. $ 5.00 Date .............. New Building · Id or Pre-existing Building ............ Vacant Land ............. Location of Property ~/.~.~. .......... .,~.~}C.~.OY'.y...t~.. ........ Hou~ No. Street Owner or Owners of Property . / ¢.~¢~..~ ..... ~¢~¢.~J .... //,...~¢.~',~', ........... co..,y No. 000 S. ,ion ........ ...¢ .......... ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. //O..~. ~. ~ Date of Permit ¢':~.q 3. (.Applicant. ~0.~. C.~.~., ./~....~/J~' ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. Z .................. Fee Submitted $',..~]~. ....... Construction on above described building and p.e~rmit meets all applicable codes ar BLDG. DEPT TOWN OF, ,SOUTHOLD , ,~ FIELD YNSPECTION FOUNDATION (1st) COMMENTS FOUNDATION 2. ROUGE FRAME & PLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY G,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1802 isapproved a/e .............. ......... ........ / .~.';i~.. P, PPLICATiON FOR BUiLDiNG PERMIT Ap plication No../?..(~..~. ~ .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building .nspector, 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 )r areas, and giving a detailed descnptmn of layout of property must be drawn on the diagram which is part of this appli- 'ation, 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 ,hall 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 Occupancy ,hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Sontbold, 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. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in buildings for nec~ons.~~~~ (Mailing address of apl~icant) grate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. tf applicant is a corporation, signature of duly authorized officer. (Nazne and title of corporate officer) Builder'~ License No .... ."~:.~'..(-:'.~..:-.~.) .......... Plumb. e~ s ~ic~nse No ......... ./ .......... I. Location of land on which proposed work will be done .................................................. House Number ' ~ ......... Hamlet County Tax Map No. I000 Section . t/.o~..,~ ........... Block ~. ............... Lot .,~..I ............... 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 ..... t~d~.~.... . ~.~.~./ ............................ b. Intended use and occupancy 9~ ..~..~~ t '. 3. Nature of work (check which applicable): New Building .... Addition .......... Alteration .. fi..~.~.'.~*'.. Repair .............. Removal .............. Demolition .............. Other Work ............... [ Estimated ' (to be paid on ~ing this application) ~ If dwelling number of dwelling units Number of dwelling units on each floor If garage number of cars q~9~&,~<: .............. L If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... L Dimensions o~ existing stmcture~, if any: Front .............. Rear .............. Deptl~ .............. ' ~ ~ Nmnber of Stories Height ................. Dhnen~i?~f same structure wi.th alterations or additions: Front ................. Rear ................. Dep~ .. ~ ................. Height .................... Number of Stories ................... L D~mens~ons of entire new construction: Front ~ ........... Rear . ~ .......... Depth . ~.~ ......... Height . ~ ............ Number of Stones ... [ ...................................... ~ ......... ). Date of Purchase ~.2~.7~ ................. ~ame of Fomer Owner ~~.~ ~ 1. Zone m use &strict ~n premises are ........................ ~ ........... L Does proposed construction violate any zoning law, ordinance or regulation: ............................. t..W~I lot be regraded ...... ~ .~..: ....... ~ ........ Will excess fill be removed from premises: Yes ., ~ [. Nme of Owner of premises ~..~.. Address lq/ff~q~r~.~ ~.'. Phone No. ~ .~Z¢. ~ Name of Architect ......... ' ................. Address ................... Phone No ................ PLOT DIAGRAM' Locate clearly ~d distinctly ~I. bufld~gs, whether existing or proposed, and, indicate ~I set-back d~ensions from -ope~ ~nes. Give street ~d block number or description according to deed, and show street nines and indicate whether tedor or corner lot. rATE OF~ NEW Y~Rm-- '/ ~ ZS oCmY OF . ~k~e2Z. ................ b ing duly sworn, deposes and says that he is ihe applicant (Name of individual signing contract) oove named. e is the ..................... ~ .................................................................... (Contractor, agent, corporate officer, etc.) f smd owner or owne~, ~d is duly authored to perfom or have performed the said work and to m~e and file pplication; that all statbments con~ained ~ this applicatioa are true to the best of his knowledge and belief; ~d that ~ork will be performed in the manner set forth in the application filed therewith. worn to before me this Quahhed m Suffolk County I ! Comm*~sion ExpLms Mdrch 30, 19'~ Examined ................ : ........................ . .... '?" Approved ........................................ , .. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Permit No ..................................... Application No ................................. Disapproved a/c ................................................ ~ ........................................... Date .............~....,.' ............................. , INSTRUCTIONS a. This apphcation must be completely filled in by typewriter or in ink and submitted in tnplicate 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 giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 wdl issue a Budding Perrmt 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 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 ~ssuance 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 applicont, ar .~e~ ff ~ ~H~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... Z. /.~r. w. J.....~ ....... ;<~;- .,,J,*~ ~ j:. . . .. . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./ - ~ . , If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Budders bcense No ............ .m-..~- .................................... Plumber's License No....~'.....~.'....~../.~....>/,~.Z Electrician's License No ..... /.~.~.~J.~... Other Trade's License No ............................................... Location of land on which prop, g.ose~d~,w~ork will be done. Mop No.: ......... C .Z...~'~.? .................... Lot No....z~ ............ Street end Number L.(~../...~. ........ .,~..~,,¢.c....7..~'~.x1~..¢../. ~..~' ................................ / /v',umclpalrry State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy ......... l~.~.~.~....~.:.~.~..//:).Z.i~.(~/.... ~.'./. ./~. ........................................ b Intended use and occupancy .................. .~.. ................ 3. Nature of work (check which applicable). New Building,. ................. Addition .................. Alteration .............. Repair ................... J~moval i .................. DemolitJon....~ ...........Other Work ................................................... /~'/~;~, '' ~/(,/~,..~, ~ ~/~ ~ ,, ~ (Description) 4. Est mated Cast ..................... ~ ..................................... Fee ......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ........................... If garage, number of cars ........................................................................................................................................... 5. f business, commercial or mix~ occupancy, s~c*f~ nature and extenf~ each type of use .~...i./.~...,~..~ 7. Dimensions,o~px~ting structures, if any: Front ~..~ ............. RearJ ................................ Depthz .................... H,ig , ............. S,or , ........................................... ................................... ............... Dimensions~f same s[ru~ture with altergti~ or add tons: Front ........ .J. ~:.. . Rear ........... ~.~ .... ~-_ ~:.~";" Height /( of Stories ~ ~-~ :,,, - Depth ............. ...... ....................... .z.~umber ......... ~. ................ ~ 8. Dimension2 ~f ~ntire new construction: Front ........... ~...., ................ Rear ............................ Dept~ ....~ ................. , . /~ . , ~ .~ ~,~ / ~eight .; .................. Nu~tories ................................... ~. ~:, .................................... ~,.~.,:,;,, .~. .............. 9. ,,on .............. .................. ............................. ............. 10. I'Date of Purchase ........................................................ Name of~rmer Owner ........................................................ 11. Zong or use district in which premises are situated .................................................... ~ ....................................... 12 Does proposed construction violate any zoning law~ ordinance or regulation: ....... ~ ............................................ 13. Will lot be regraded ..... ~.;~.:: ............. Will excess fill be removed from premises: ( ) Yes (~Z~ 14. Name of Owner of premises .................................................... Address ................................ P~one No ....................... Name o¢ Architect .............................................................. Address ................................ P~one No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM I_oc~te clearly and distinctly all buildings, whether e~isting or proposed, and indicate all set-bock dimensions from prope~y lines. Give street and block number or descrj~n according to deed, and s~ow street names and indicate whether interior or corner lot. - ................. S'I'ATE OF NEW )~DRI~, ~ / I ¢ S ....... ,. ........................................................................................ being duly sworn, deposes and soys that he is the opplicanl (Name of individual slgping contract) above named. He is the ~.:'. ............................................................................................................................................................................. , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work wJJl be performed Jn the manner set fo~h in the application filed therewith. Sworn to bede me this ~4 JUDITH T. BOKEN '~amre applicant) Nolaw Pub ~, ~late of New York ~'~ No. 52-034~63 Suffolk Cour~ Commission E~pire~ March 30, 19~ W~s7~