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Home My WebLink About13485-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13073 Date December 18 198.4.. THIS CERTIFIES that the building ............ .A,dfl. i..t.i.o.n. .......................... Location of Property .. ............. R.,9..W.:..o.f.f..C. 9.m.~p. Mineola Rd. Mattituc]~' .......................... l-louse IVo. b'treet County Tax Map No. 1000 Section . .1.2..2 ....... Block ...0.7 .......... Lot 003 Subdivision ...... X Filed Map No ...... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept. 25 19 84 pursuant to which Building Permit No. 13.485Z dated ........ O..c.t.o.b.? .~ .... 2. .2 ......19...,84 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 ......... Deck Addition to Existing One Family Dwelling DAVID STRONG The certificate is issued to ........................................................... (owner, ~rterran# of the aforesaid building. Suffolk County Department of Health Approval ...... .N/.~. ................................ UNDERWRITERS CERTIFICATE NO .............. .N/.~. ................................ Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13485 Z Permission is hereby granted to: ..~.& ..~k.~.-s~ ..... ..... ~...~.~.IL~.~.~ ............. .... ..N. ~~.'...'.~..,.~,:....~.L~.~ . -~----~ ...... ~--"~ ~ '."'~ ~, n~:""~ ..... ~ ;-'~ ...... at prem,ses I~at~ at.:.....~,..~.,.~..,...qb...~F.....~~....~,......~~ Coun~ Tax Mop No. 1000 Section ..../...~.~ ...... Bilk .......~ ..........Lot No.....~ .............. ~,,,.,, ,o ~,,,i~.t,o. ~.,~ .~.~.....~....., ,,~.~.., ~,~ ~pro,~ ,, ,~e Building Inspector. Building I~tor Rev. 6/30/80 FORM NO. 0 TOWN OF $OUTHOLD Building Department Town Hall ~ ,~)outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY In;tructions A, This application must be filled in Wpewriter OR ink, and submitted,~x=~4eet~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. Corr~mercla bud ngs Industrial buildings, Mu tlple Res dances and similar buildings and mst.a, lla- tions, a certificate of Code compliance from the Arch tact 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 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/ land use 3. Copy of certificato of occupancy $1.00 --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date (,~--~ 4 "°cd New Building .... ~ ........ Old or Pre-existing Building ............ Vacant Land ............. House No. ' ..... Street ................... ~lamlet Owner or Ownar$ of Property ..... (~ ...... ~ .............................. County Tax Map No. 1000 Section ..... /, .Z.,. ,~, .... Block ...... ~ ........ Lot ..... ~,, .......... Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Final Certificate Request for Tempora~ry~Cflrtificate ............................................ Fee Submitted $..'~..,~. · .................... Construction on above described building and pe~rmit meets al applicable codes and regulations. ~ Applicant ....................... FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY G,ODE FINAL COMMENTS ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 705-1802 :~xamined .0..~...~....~..%.., O.~...~. ~'.%" 19~.~ Permit N ~.pproved ...... .. o ............ Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date..~..~....~.~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Insp¢c ets of plans, accurate plot p!an to scale. Fee according to s.chedule, b. Plot plan showing lobation of lot and of buildings on preiniscs, relationship to adjoining premises or public streets ,r areas, and giving a detailed 'description of layout of property must be drawn on the diagram which is part of this appli-. ation. c. The work covere'd bl/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 hall be kept on the premises available for inspection throughout the work. e. No building shail 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. ,APPLICATIO .N. IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant t'q the luuding Zone Ordinance of the Town of Southold, Suffolk Cgunty, New York, and other applicable Laws, Ordinances or ~egulations, for thc construction of buildings, additions or alterations, or for removal or demolition, as herein described. ?he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to .dmit authorized inspectors ou premises and in building for necessary inspectio~..~ (Signature of applicaut, or name, if a corporation) (Mailing address of applicant) gtate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. :',lame 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 cm~porate officer) , Builder's License No ............................ Plumber's License No ......................... Electrician's License No ...................... ,. Other Trade's License No ............ I. Location of land on which proposed work will be done...... -/.. Itouse Number Street Hamlet County Tax Ma~ No. I000 Section ....... .... Block ........ Lot .. Subdlvisiou ..................................... Filed Map NO, .; ............ Lot (Name) State ex/sting use and occupancy of premises and intended usC and occupancy 'of proposed construction: a Existing use and occupancy /~.~ · b. Intended use and oct~upancy .................................................................... 11. Zone o.r use district in which pr~mises are situated ............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regra, ded ........................... Will excess fill be removed from premises: Yes · re owor e lc a c : ew ng ....... 1 ...... Alteration Repmr .............. Rem?al ......... , Demolition ..... Other Work ............... , .~..~.o?. --~.~. ~ (Description) 4.' Estimated Cost 9. : Foe. ;. , ' *'. (to be paid on filing this application) 5 lfd 11' robe old ellingI · N ofd elli units ch floo · we lng, nu r w. units .............. umber w ng on ea r .............. . If garage, number of cars ....,,....: ........................................................... , 6 If business commercialor mixed' ' occupancy' ~ SPecify nature and extent of each type of use 7 Dimensions of existing structures, 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 construction: Front ' Rear Depth Height ............... Nm~ber of Stories ................................................ Size of lot: Front Rear ' Depth Date of Purchase ~ Name of Former Owner Name of Architect ......... Name of Contractor. ....... 14. Name of Owner of premises .................... Address ................... Phone No ................ ................. Address ................... Phone No ................ .................. Address ................... Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all, buiklings, whett~er existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block i>tion according to deed, and show street names and indicate whether interior or corner lot. ,'TATt'~ OF NEW YORK, SS ?OUNTY OF ' NOTIFY BUILDING ~XRT~NT A~ ff65-1802 9 AM TO 4 PM FOR THE FOLLowING INSPECTIONS: I. FOUN~nATION . TWO REQUIRED FOE pr~URKD CONCRETE 2. ROUGH - FRAMING & PLUM~ING 3. INSuLA ~Obl 4. FINAl C()N'STRUcTION MUST BE C ~,'!PLrTE FOR C, O. ALL CONSTRUCTION SHALl. MEET T~tE RE9t Jl~%M~S OF TNE N, Y, STATE CONSTRUCTION'& ENERGy COgES. NOT RESPONSIBLE FOR DESI6N OR CON~RU~ION E~RORS. ............................. ; ............ ....... .. being duly sworn, deposes and says that he is the applicant (Name of individual signing confi'act) bove named. le is the ...................... f said owner or ow~e~.~d is dui author~od to perform or have performed the said work and to m~e ~d file this pplication; thatia~ statements conii ined ~ this application are true to the best of his knowledge and belief; and that the fork will be,performed in the m~m r set forth in the application filed therewith. worn to before me this .. ' ~t[~,~o~ . .' .. ~1 ~UBtltCgtalo et ~ew vmk (Signature of applicant)