The URL can be used to link to this page

Home My WebLink About13078-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15330 Date March 6, 1987 THIS CERTIFIES that the building . , Screened Porch Addition 2600 Oregon Road Mat'tituck, N.Y. Location of Property ~t$ds~ ~/o~ ....................... ~/e~' ....................... P~r~/el County Tax Map No. 1000 Section 100 .Block 4 ........... Lot 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 23, 1984 13078Z ........................ pursuant to which Building Permit No ...................... dated Ma y I , I 984 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... SCREENED PORCH ADDITION TO EXISTING ONE FAMILY DWELLING WILLIAM HEINS The certificate is issued to ..................... [o~n'e),'ld,~b'~t~t$~'~'~f .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION BATED: N/A Building Inspector Rev. 1/81 lrOB,~ NO. 0 ?OWN OF SOU'fi'tOLD BUILDING DEPARTM£NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13078 Z Permission is hereby gronted to: ........... ................... ............ ~, d~.-.~, ~.{.Y../-. .............. .~. d...'~ .................... ~ ,,~, ,o .......... ~,.o.,~.~.7.~...u...(..>..~......~. ~'~..~:~.~.....zrh,~..-L..~...~,z.(..(z/.~ ....... (. ....... ~N~....~.~t~.7...~.~.....,&~a.../.b_,.~:~' ' ~._ ~- · .................................................................................. ot prem,ses located ot ........c~,(g)...~.~1 ........... ~4~/,~.(~,~.../...~.¢~g. ................ = ....... .; ......... ................................................................................................................. Cou.ty Tox Map No. 1000 Section .... 4~....~.....::.. Block ~..~...~ ............ Lot No...~,~ii ............. pursuant to application dated ...... ,~/..~.:-..~-...,~........~--~.~. ......... , 19~..~'.~., and approved by the Building Inspector. Fee $~/~....~ .......... Building Inspector Rev. 6/30/80 FORM NO. G TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions ,~obiS application m.ust bo filled in tVpewriter OR ink, and submitted m ~ to the Building In~pec* r with the followmg; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property Ilneso streets, and unumal 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 complTanco 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 "pro-existing" land uses: 1. Accurate survey of p=operty 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 coda or safety inspection of buildings or premises, or other pertinent informa- lion required to prepare a certificate. C. Fees: ' 1. Certificate of occupancy tlew Dwelling. S25.00, ^cce,.~ory..$10.O0 tluafne,~;~ $50.00 2. Certificate 6f occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00~ over 5 year9 $10.00 4.Vacant Land c.g. $ 20.00 3/6/87 5.Uodated C..O. $ 50.00 Date .......................... 6. Alteratlon $25.00 New C on ~ t r u c t, i on Old or Pre-existing Building Vacant Land Location of Property ............................................ House iVo. H,)n;l~ t Owner or Owners of Property .......... -..'.' ........................... County Tax Map No. 1000 Section .... 1.0.0. ........ Block . .~ ............. Lot .... ,5 ........... ' ' ' Flied Map No Lot No Subd~ws~on .......................................................... ?ermit No./,.~, ?~. ,~, Date of Perml~.~,~ ,~,t..Appllcant .................................. Health Dapt Approval Labor Dopt Approval · Underwriters Approval Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... .~ 25.00 Fee Submitted .............................. Construction on above described building and permit meets all applicable codes and regulations. 10.1078 Applicant .................................................... William H. Heins FIELD IN s3~E f',TION COMMENT~ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 · rOWN I1ALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 Ctls is Co advise you that the job under building permit no. 13078Z issued to William HeiRs on 5/1/84 for ~ddition ia eomple['ed a fJ~7;~--i--~p--~tlon has ( ) has not ( X")--been done. and £n order to complete this file, it is necessary that a Certificate ef Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate te Whom the Certlficnte of Occupancy ia to be mailed, and arrange with this office for an inspeCtiOn (late Occupancy or use in unlawft,! without a Certificate of Occupnncy. l'le~ne, help .s to clear np th{s matter so that legal action does not h,~ve to be ~aken. Thank you for your prompt attention. Very truly y~, Victor Lessard Executive Administrator VL;gar enc I . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved....~f..'~.(.{.).. d..., 19 ... ermit No .......... Disapproved a/c ........ -:-r:-.~:.......~----~-~. ~ ...... ' ............ ............ ...... ......... .... · ..... (B m~ g Inspector) APPLICATION FOR BUILDING PERMIT Date ..~'~-~. ~.. Application No.. ~C~./~.. ...... INSTRUCTIONS a. This application must be completely ~led in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. 1o. 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 issue 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 Occupahcy 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 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 applicant, or~.u, ame, if a cprporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contr~/ctor, electrician, plumber or builder· ................. ~.~.~.~ ................................................................ : .... ' ' -/. ' Name of owner of premises ....... [4.~-~.1.0.~.q%.'~ /'.- ....... g t.,~,, ....~ ~(I ................................ (as on the tax roll or latest de~"d)d) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... t../;~. ~ ............... Plumber's License No ......................... Electrician's License No ....................... Other T~ade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ........... -~.~ ~z .... q~--.~..~..~.../~-...' .................... ~.'./.~/.o. k ............... . House Number ~/Street Hamlet ' Cg¢nty Tax Map No. 1000 Section .~.~v.D.C,>.--J.~.4¢.-: fJ-.,ff~/Block ......... ; ........ Lot. ·. '. ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ?).~. (YLfi. ...................................................... .~-,~ ~,. · b. Intended use and occupancy L~ ~. '~-, ~ ~ .................. i 3. Nature of work (check which aplplicable): New Building .......... Addition ...... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............... i "- -- (Description) F 4. Estimated Cost ....... · .................. ee ......................... ... .. [ (to be paid on filing this application) 5, If dwelling, number of dwelling Units .... U~. ....... Number of dwelling units on each floor...[. ............ If garage, number of cars . .~ ............................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .- ;~:~"7~ ............. 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories '. ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. ' Height Number of Stories ' Depth .................... ' ............................................. 8. Dimensions of entire new construction: Front .. ~-~.~.. t Rear ... ~ ~'~ .' Depth ./4-~. ( .,-/, ~ r/ Number of Stories Height .................................................................... 9. Size of lot: Front .......... ~ ........... Rear ...................... Depth ..................... Date of Purchase i Name of Former Owner 1 I. Zone or use district in which promises are situated .................................................... 12. I)oes proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ........ ~ ..................... Will excess fill be r_en~oved from premises: Yes ~ No 14. Name of Owner of premises ~C!t~[,Q227..~('~/~. Address t~7..~ '~?/./~7~ ....... Phone No. ,;~?~D.~: ~. ~.7. Name Of Architect ......... i ................. Address . ~/2~44~r/4/7. ........ Phone No ................ Name of Contractor ......................... Address ................... Phone No ................ Locate clearly and distinctly all property lines. Give street and block!number or description accordin interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from to deed, and show street names and indicate whether ¢1' STATE OF NEW YJ~RIC¢/ ~,/ IS.S CO (Name of individual signing contracB' above named. I 4 ~o'-- o" I/ being duly sworn, deposes and ~h~'that he is the ap flic~t He is the ..................... ! .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du,ly 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 will be performed in the manner set forth in the application filed therewith. Sworn to before me this i ................... ' ' - ,, Notary Public, . ,/~----q--~47~. ~-~.'.~ /~ ~b.~~ ~- /W~ ~~V~ ~ ..~N ~ F_.~: .... ;....;....: ~~ 8u~o~ ~un~ ~ ( I Si~amre OI appllC~O