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Home My WebLink About12882-zFORM NO. 4 TOWN OF 50UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16572 Date January 8, 1988 THIS CERTIFIES that the building , .C.o.n.s.t.r.u.c,t..S.c.r.e.e.n.e.d..p.o.r,c.h. ,e.n.c.l.o.s.u.r.e. ,a,d.d.i,t.i.o.n..,. Location of Property 3705 Breakwater Road Mattituck, New York House No. Street Hamlet County Tax Map No. I000 Section 106 .... Block 03 .Lot 027 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated February 14, 1984 pursuant to which Building Permit No. 12882 Z dated . . . .~?.b .r .u .a .r .y. .2 .3 : . !.9.8.6 ........ 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 ENCLOSURE ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued toHERBERT DRAPE ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ............. .N./.A .......................... N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOW~t~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDIHG FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12882 Z Permission is hereby granted to: .... z.~.~...~..q...~ ................... i' ................ ,_ ......~.,.~..,~.~.~...~.../..... ........ .... Z~.....~~ ........... :~.~~ ........... ~r~....~.~D....~ ..~./~..~....~z_~...~/~ ....... ~: ....... ~....~_~ ........... ot premises I~ated at ....~7~ .......... ~~~ ....... .~. ........................ ............................................................................................................... ~~...~:~.,.~ ........................ ~.~..~.~...., ....... ,~.,,~..~_~ ........................................ :~ .................. pursuont Building Inspector. ' Bu~fding Inscector Rev. 6/30/80 FQRM NO, 6 TOWN OF SOUTHOLD Bu tiding 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 subm{tted ~ II~m,m.~l~ 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 topo,qraphic 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. $.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 pzToperty strawing all property lines, streets, buildings and unusual natural or topographic featu res. 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; Additions $25 .00 POOLS $25.00 1. Certificate of occupancy New Dvzelling $25.00, Accessory ,$10.00 Business $50,00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..................... / .~..,/ NewCona tpucti on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... ·. ' .G, .......................... House No. Street Hamlet Owner or Owners of Property ... ':~:... ~:~l. LV/'.'.,;:. ................................ County Tax Map No. 1000 Section lz:~:; Block Lot .'. ........... Subdivision .......................... ; .................. //~..~ ~,.. o~, .~ !I,I .F lied Map No ........... Lot No. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept Approval ' Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificato ..................... Final Certificate ....................... eeb pratt dS, ..., .... : TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. /_~ An application for Certificate of Occupancy is not on file. ~ce~ /Z~ No Underwriters Certificate on file. /~' The check is(outdated/~) ~2~dO /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation, ~uilding Permit # _f__~.~. ~ F ~ Z Building Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 76.5-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION FRAMING 2ND [ ] INSULATION REMARKS: INSPECTOR ]WELD,INSPECTION FOUNDATION 1st) FOUNDATION 2nd) 2. ROUGH FRAME & FLUMBING INSULATION FER STATE 'ENERGY ~ODE FINAL COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined 7~-~- ~e'~ ,i9 052¢ Approved .~r'.~..' ! Disapproved a/c ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received. 2'~"/i,¢/. 19~..~ 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 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 reguhtions, and to admit authorized inspectors on premises and in building for necessary in§pections. .... ,~ .~: .~...z'~.,..b.. d.~.~..¢.~...5'..~.~ ......... (Signature of applicant, or name, if a corporation) · ~_x/. 5.q.o. ~...w. q~?. ~ .~ .<a.~.., .~ ~./.'/. 7~. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ........ ?. ~.,g~'.~.~.... ~..~. ?74./4.4'.~.~./.~ ........................................................ Name of owner of premises . ./?[./~..4-..../~..~.~. .... -~......~...~..~. '.~. ...................................... (as on the tax roll or latest deed) l~s a~~re of duly authorized officer. . Plmnber's License No ......................... Electrician's License No ....................... Other Trade's License No .................... 1. Location of land on which proposed work will be done· . .~..~..~?./.~..~/.~.~].."~..~.~v.~..~.../~...~7.3~.~..~... ~ ..... .......... 77.o.. ~-7.'. ....................................................................... House Num her Street Hamlet County Tax Map No. I000 Section ../..(.)..~. ......... Block .... .~..~ .... ' ...... Lot....(J...'~.? ......... Subdivision (Name) Filed Map No. . ,/.d7 ....... Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy d52~; .~.~../~./&/./ b. Intended use and occupancy .... .~.~L°. . .~>~..~../~.~ ?~ .... '?..~.~...~.. ........ ............ , ............... 3. Nature of work (check which ~pplicable): New Building ......... d ........ Alteration .......... Repair ..............Removal ............ Demolition .............. Other Work ............... :,.. (Description) 4. Estimated Cost .................... 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 , 6. If business, commercml or m~xed 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 strncture with alterations or additions: Front .... : ............ Rear .................. Depth ....................... Height ....................... Number of'Stories ...................... 8. Dimensions of enti,,re new consiruction: Front ·../'~...,...." . Rear ./. ............ Depth .... ~ .......... Height .... /.~. ........ Number of Stories ' ' . ' . .... 9. Size of lot: Front .......... ~ ............ Rear ...................... Depth ...................... 10. Date of Pnrchase .......... ................... Name of Former Owner ............................. 1 1. Zone pr use district in which p~emises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation' ,~O . . 13. Will lot be regraded . . .~.,O. . Will excess fill b ' n~' ' '~ ;' .............. - .......... ....... : .................. e re ovea trom premises: 'Z ~_.Y. es T No 14. Name of Owner of premises ......... Address . . Phone No ~ ~' ~' ~'... Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor .~..~..7' .~..~'~. ~,.,~.f,., .~.~..~... Address .~.~ ~P.~...t~.~l.~L~.q gd~hone No...~.-.~-~.~. .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. TATE OF Nr.w/i ORK, "S " 'f -" ¥fi; 'didi &'sili ii' ' 'c'o'n't;ic'6 .......... above named. being duly sworn, deposes and says that he is the applicant 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 will be performed in the manne~ set forth in the application filed therewith. Sworn to before me this ............ ./.)....._... ......... i ~,,,i,~ ,~,? ~,r,~ a~, ~_~ (Signature of applicant)