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HomeMy WebLinkAbout13577-zFORM NO. 4 TOWN OF SOUTHO~D HUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, NoY. CERTIFICATE OF OCCUPANCY No: Z-25656 Date: 04/17/98 THIS CERTIFIES that the building WOOD STOVE MATTITUCK Location of Property: 4015 WICKHAM AVENUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 107 Block 9 Lot 3 Subdivision Filed Map No. __ Lot NO. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 8, 1984 pursuant to which Building Permit No. 13577-Z dated NOVEMBER 23, 1984 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 WOOD BURNING STOVE IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GERALD & STELLA WALTS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO, PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13577 Z Permission is hereby granted to: ....... ........................ .... ,~ ....... ~.....~.: ...... I.L~.!.~ ...... ~'o ....................................... ~..-,~,~'~...~....~....~.., .......................... at premises located at ..~,~L.~..(e.~ ...... .~.~~..1~ ....... ...I~L~ ........ Co~,n~ Ta,~ mo~, No. lO00 Section ...... !...°..2 ......... e,ock ......... ~ ......... Lot No. pursuant to application doted .... ~.~~ ....... 3 ............... , 19.?...~.., arid approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all bui%dings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Ppre-existing" land uses: io Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2, A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, ~' Additions to accessory building $25.00. Businesses $50.00. 2. Certificate. of Occupancy on Pre-existing Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - = .25¢. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential,S15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ............... Location of Property ............................ ~- ........................... ' .... House No. Street Hamlet Onwer Owners of Property ...... Co,,nty 1000, Seetion...t.O.. ...... ........... .ot .... ............... Subdivision .................................. Filed Map ........... ~.Lot ........ ~..~ ......... '~.~.?.?.~..::.Date Of Permit ................ Appiicant'~''~'' ''~'''~''~'""~'- ............ permit No ..... Health Dept. Approval .......................... Underwriters Approval Planning Board Approval ............. Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: APPLICANT TOWN FORM NO, 6 TOWN OF 8OUTHOLD 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 cml to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of propertv with accurate location of ali 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. 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5 00, over 5 years $10/.00i 4.Vacant: Land C.O. $ 20.00 ' 5.Updated C.O. $ 50.00 ,,,//,Date .... ~../.~..O. 1..~.7. · · - , _g_m._mg . .. Vacant Land .. . ...................... ¢.. ..... House No./'it' Street Hamlet Owner or Owners of Property ?.? .j" · County Tax Map No. 1000 Section,/ ..... Bloc ........... Lot ....... Subdivision ............................. ~,..Filed Map No ........... Lot No .............. ..- . ¢. Permit No ~ ''~'') 2-~ , ~ ......... L~ate or ~'ermit .u. .Applicant . . ,~..~..c, .'~, ............. Health Dept. Approval ........................ Labor Dept. Approval .................. Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... FeeSubmtted$ /~,.0(~ Construction on above described building and p.e~mit meets all applicable codes and regulations. ApplicanL, ,,/. ~¢. 14.~..~, d,..1~/~', ~- ........................... Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD Town [{ALL, SOUTHOLD, N. Y, t197l 765-1802 April 20, ~987 Mr. Gerald Walts 521 2nd Street Brooklyn, New York Re. Bu~ldx g 11215 Permit #13577Z Dear Mr. Walts: We received your check in the amount of $10.00 for Certificate of Occopancy regarding the above building permit number· Kindly fill out the attached application form for CO and notify us when would be a convenient time to set up a final inspection. Thank you, SOUTHOLD TOWN BUILDING DEPT. F~ELD'~NSPECTION FOUNDATION (1st) COMMENTB FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y, STATE ENERGY ~ODE FINAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 1197l TEL. 765-1802 This is to advise you that the job under building permit no. 13577M issued to Gerald Walts on 11~23/84 _ for Accessor~ is completed and a final inspection has ( ) has not ( x ) been done.~ In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.OOpayable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly youths, Victor Lessard Executive Administrator VL:gar enc[. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 April 22, 1987 Gerald Walts 521 2nd St. Brooklyn, N.Y. 11215 Dear Mr. Walts: We received your application today and I have put it in your file along with your check. In our letter to you we .asked you to notify us when we could do the inspection. Since you did not mention a date when we can do the inspec- tion please call us or write to us regarding the inspection. Thank you. Yours truly, Secretary Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 March 24, 1998 OFFICE OF THE BUILDING INSPECTOR TOWN OF $OUTHOLD Gerald Walts P.O. Box 602 Mattituck, New York 11952 Re: Building Permit # 13577-Z WOOD BURNING STOVE Premises: 4015 Wickham Ave., Mattituck Suff. Co. Tax Map #1000-107-9-3 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so may clear up this matter. Thank you for your cooperation in this matter. that we Very truly yours, SOUTHOLD TOWN BUILDING DEPT. P.O. ~ 765 PROPOSAL SUBMITTED TO Er. Wa~s Name Street 521 2nd. S+reet City Brooklyn Telephone State NY 11215 Page No. 1 Date 0Ct. 29, 1984 WORK TO BE PERFORMED AT Street 3765 Wickham Ave, City_ l~attituck, State Date of Plans OCt. 29, 1984 Architect __ We hereby propose to furnish all the materials and perform all the labor necessary for the completion of __ Option #l Remove oortion of_exi~t~ w~]! ~o in~ll 21 fe~ Pro-Jet~Steel p~e-Fabricated_Ghi~Lney i,n air shaft. ~upply and install 7" of black pipe from stove to 1357.23 ~ption #2 'Remove exis~zng beaver board and mol~{n~ o.f ~'6" X ]3' wall Replace with½" sh'eet rook, spackle and ~eL~n~t~l~ e3h molding $226 00~, ' Building pe~it to~e obtained by O~er, ~ : ~AI~ ~ateflal is guar~{~ed to be as spec f ed, and the above work to be Pe~0rmed m aceo~dap~wtth ~awlngs a ~ H' "~ .... ~ ~ with payments to~ made as folloWS~ ~ ~' ~> ' ~]{ ~e ~]~ d0~; b~3~nce upon comple~ion. Ple~e si~~ ~ retu~ Wh*~ ~ ; H An~ alteration or deviation from above specifications involving extra costs, wHIbe executed 0nly upon Writteh orders, and will extra cha~ e over and'above the est mate A agreements cent ng~ht uponI strikes accidents pr delays beyond our , ,g - , ~' ' e~'gCom"ensation and PBblic ' fire, tornado and other necessa~ insurance upon above worR. Workm p ~ , , ,, Liabil~y Insurance o~ above work to be taken out by The '~ ~ m~y 'dhecker ina. 1 Respectfully submitte~~'~ Per ~iNOTE:; This pj'oposal r~ay b~ withdrawn by us if not accepted Within The;above~rlces, specifications and Condit ons are ~a~.Sfa,c!0rY pay[neht w be made as ou Signature Signature the wor 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING DATE INSPECTOR ,~.f/~.~. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] FRAMING [ ] INFLATION · [ ~]'~INAL FIREPLACE & CHIMNEY DATE ~'~ INSPECTOR /4' 765-1802 BUILDING DEl:ri., INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSU/LATION [ ] FRAMING ~]~4NAL [ ] FIREPLACE & CHIMNEY DATE INSPE _ BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ I ROUGH PLBG. [ ] FOUNOATION2ND [ ] INSU~.LATION [ ] FRAMING [ ] FIREPLACE & CHIMNEY FROM THE DESK OF Gerald Waits FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined ./0~.. a&.., 19~.?. Approved .~. ~..~. ?..~.., 19~. Permit No../~g~.? .~..~;. (~A 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 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 of property must be drawn on the diagram which is part of this appli- 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 issued 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 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 tile Building Department for the issuance: 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 building for necessary inspec~ ~...~..~.. (Signature of qpplicant, or name, if a corporation) .... !.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... O.~. ~. ¢..~. ................................................................ Name of owner of premises . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ..¢..'..,:...7... Builder's License No... ' ~ ~ ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No...~..~..~.1...~...~... ...... Location of land on which proposed work will be done .................................................. · ..... .... g ............ .......................... House Num bet Street Hamlet County TaxMap No. 1000 Section.. J..0..~. .......... Block .... .~...~ ......... Lot,...~...~.. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of propos~?onstruction: a. Existing use and occupancy ...~.(~, v ~.4 ~... ~ ~ ~.1.~. t~.ff.~.~ .............. ["/'x.~,~. .................... b. Intended use and occu anc ...... !.t .... ~ ' Natureof work (check which applicabl'~): New Building ..... ' .....'Addition . .j ........ Alterati~ ......... Repair .............. Removal ............ Demolition ........... ... Other Work ............... ~ ~,~ff' O t) ! (Des&iption) Estimated Cost !~0 b:o o .. Fee ' (to be!paid on filing this application) If dwelling, number of dwelling units.. ~ . Numberof dwelhng' unitsl on each floor .... If garage, num bet of cars .......... ' ................ If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..................... Dimensions of existing structures, if any: Front ............... Rear"..:... ] ....... Depth ............... Height ............... Number of Stories ........................... 4 ........................... Dimensions of same structure with alterations or additions: Front .~..~r7 ...... ; ..... Rear .. ~.~.' ........... Depth ...................... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ............... Rear ....... i ....... Depth ............... J Height Number of Stories , ~. Size of lot: Front ............ ~ ......... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner i .......................... 11, Zone or use distriqt in which premises are situated ...................... i. , Does proposed construction wolate any zoning law, ordlnance or regulation' I~.J) ................ 1~. Will lot be regraded ...~, ,O,, ..................... Will excess fill be rem ~d from premises: 14. Name of Owner of premises .Y..l~.~.~.. ~.. ,~. ~.0..~..' Address .... 7v . No ......... ..... Phone No ....... : ......... ......... · ,.~-.. ! ..... Phone No .... ,.. ......... ~, Nanae of Architect ........................... Address ~.'O .~ '7.6,5 ~. ... Phone No. ~.q. ae:57qY.~ .... Name of Contractor g..[tj.~..~.~ ~[..~ ~.~ .~.~.~ ..... Address . 'l~)~J ~ ,1 ~ ~ ~' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. i~dieate all set-back dimensions from .p~operty lines. Give street and block number or description according to deed, and sh~w street names and indicate whether interior or corner lot. · 765-ts0~ 9 AM TO 4 ~M gO~ ~HE' ~OLLoW'JNG INSPECTIONS: ~. FOUN'DATION . TWO FOR POURED CONCRf~E 2. ROUGH - FRAMIN~ & 3. I ' NSUL~ T ION 4. FINALi. CONYrRu~T~O'N' MU~'f ALL COFiS'r'R UCTtON ~HE RE©LIfprMENTS Of: TH~ N.Y. S ' STATE OF NEWYORK, S S [TATE CONSTRUCTION & ENERgy ~ODFS. i NOT RESPONS~BtE ~OP COU~Y OF ................. ~ ~fi~ ' ~N. ............. ~. ;¢,-~.~. · · ~.~.~ ............ being duly sworn, deposes and says t~t'~e ff meappnca.t (Name ofindividuai signing ~ontraot) . : above named. , He is the ........................................................... '. ................... : .......... (Contractor, agent, corporate officer, et~.) of said owner or ownen, ~d is duly authorized to perform or have perfo~ed ~ s~d work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application filedtherewith. Sworn to before me this $otaw Public, .......... ~( ~. ............. County I~ CATHER~N'E GAFN~R _ -- / No, 2~697958 '' ' ' ....... Qualified in Kings ~n~ ~ (' (Signature of applicant) ~Isslon ~pltes'Ma~eh ~, t~