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Home My WebLink About13247-zFORM NO. 4. TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. Certificate Of Occupancy · Date March .13, 1987 THIS CERTIFIES that the building Accessory ~ Location of Property b&~ 9080 SOUND AVE. 'MATTITUCK $'o ~o~ ........................................................ Street Hamlet County Tax Map No. 1000 Section . ! .2.2 ....... ~Block . 2. .Lot I. I Subdivision ................................ Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3'u n e 212. 1984 pursuant to which Building Permit No. 13247 Z dated ..J.u.n.e.......................21, 1984 . ..wasissued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Construct a canopy, over an a.ccessory slab in the rear yard. The certificate is issued to STANLEY SEPKO (o wn or, 7~ 7;d~;~l) of the aforesaid building. Suffolk County Department of Health Approval ......................................... UNDERWRITERS CERTIFICATE NO ................ N/A .............................. PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 l~OUM NO. S 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) N? 13247 Z Date ......... ~ (. ............. Permission is hereby granted to: ......... ................... o~ ~ ....... otprem,.s'ocotedot...~.~ ...... ..~ .... ~ .... ..~.~ ................ County Tax Map No. 1000 Section .... /...~...2~.. ...... Block ......... ~ ........Lot No ....... ].:..]. .......... pursuant to application dated ....... ....~..~...~..J. ................., 19.~...~., and approved by the Building Inspector. ~' BuiI' 'ding ~ln.~pector - Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11B71 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Q'his application must bo filled in typewriter OR Ink, and submitted ~ ~ to the Building In~pec- "[or with the following; for new buildings or new use: 1. Final survev of property with accurate Iocatio, n of ail buildings, property lines, streets, and unusua~ natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dlsposal-(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 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. Certif[cate of occupancy New DwellJ. n.3,$25.00, 'Acce,,~ory ~10.00 Uu~e~ ~50.00 2, Certificam of occupancy on pro-existing dw011ing ~ 5 0.00 3. Copy of certJ~icate of occupancy $ 5.'00, over 5 yeare $I0.00 5.Updated c.g. $ 50.00 Date ........ 6. Alteration $~.00 New C oas ~ ~uc, ion..~. O,d or Pre-exi~~~~.~ ......... Vacant Land ............. ~ ..... ............ . ........ County Tax Map No. 100OSectmn ./~. ~, Block ........ ~... Lot.. ,Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./,~..~'2.~Date of Perm,t, . ppllcant ...... pt. Ap~l ,. Health Dept. Approval ........................ Labor Do ..................... - Underwriters Approval ~ Planning Board Approval ' Request for Ternpora_.,ry Certificate... .................. Final Certificate ........... Fee Submitted $.~i~,f.l..~,,...~...~. .............. ' Construction on above described buildin{] end permit meets all applicable codes and regulations. Applicant · C.g. FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFF1CF. OF BUILDING INSPECTOR P.O. BOX 728 '['OWN tlALL SOUTtIOLD, N.Y. 11971 TEL. 765.t802 This is to advlae you that the .job under building permit no. 13247Z issued to Stan±ey Sepko on ~ff.~1/84 ___ for ' access0~' "i'~ c6'mple~ed a final inspecClon has ( ) hae not ( x"')' 'been done. nnd In order to complete this file, it is necessary that a Certificate of Occupancy be iesund. Please fill edt the enclosed form, return same to the above o,f~iee with a cheek lotS10.00 payable to the Tows of'Sout~hold. Please indicate to Whom tile Certificate of Occupancy is to be mailed, and arrange with this office for an inspection (late Occupancy or .se is unlawful without a Certificate o~ Occupnncy. Please, help vs to clear up th.~ matter so tha~ legal action does eot have to be taken. .1 Thank yon far yo.r prompt attention. Very truly_~, Victor Lessard Executive Administrator VL:gar encl . , ~'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL , ,~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..i~ .-t'J'~. · . .~,1 .... , 19 8?. Approved.. ,.O,A%..~..I ..... 19~ 5. Permit No.).~,..~fi.?.~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date .................. , 19... 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 the Building Departmept 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 inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises [ ,~:: ~',[..,,., ........ .~ .;:.,f'.i~/f,.*{:a'../. / (as on thee tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) 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 .................................................. 90 o 4 -, .v.: :,: ......... ......................... ~. ~ >;,.,~.x3 . ...... ? ( .'/ ~ ...................... House Number Street Hamlet County Tax Map No. 1000 Section ..... /...-~..."~. ......Block ....... .~. ........ Lot.. J' /' Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exlshng use and occupancy ....... : ................ t...i ..... ¢ ...... {. '.:J. :fi. (? ........................ b. Intended use and occupancy . ................................................................... 3. Nature of work (check which applicable): New Building ..... '~ ....'Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4 Estimated Cost ~ Fee , q' (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 ' 6. If business, commercial or mixed2 occupancy, specify nature and extent of each type of use ................... 7. Dimensions of existing structure~, if any: Front ................ Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth .................... j.. Height ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Number of Stories ....................................................... Size of lot: Front ..........., ........... Rear ...................... Depth ...................... Date of Purchase ~ Name of Former Owner Zone or use district in which preraises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... I ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...; ................. Address ......... . ......... Phone No ................ Name of Architect ...~..W.~.~..~. ............. Address .~29~1./~.~,~. .... Phone No. ~..~.~ :.~.g~.~.~g?~ Name of Contractor ......... i ................ Address ................. Phone No ................ ~9. 10. 11. 12. '" :' '" ' PLOT DIAGRAM Locate Clearly and distinctly all ]buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give s~reet and block ;lumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ......... ........ jS.S ~ being duly deposes and says that he is the applicant ................................................., Sworn, . (Name of individual sighting contract) above named. He is the ...................... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty authorized to perform or have performed the said work and to make and file this application; that all statements cont0ined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this HELEN K BE V0£ NOTARY PUBLIC 8tare 0f New Yod{ ' . / (/ (Signature of.. applicant) , No 4707878, Su ok C I nt~L