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Home My WebLink About13130-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No, Z15410 Date March 24, 1987 THIS CERTIFIES that the building Addition to accessory building. I400 Wickham Av~. Mattituck Location of Property P~sb }V'o] ....................... k~/e~' ...................... "/~/e~ County Tax Map No. 1000 Section . . ! .3 .9 ....... Block 03 ,Lot 048 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Pemlit heretofore filed in this office dated ,..MAy. . ! .6 . ! .9.8.4 ...... ' ,,, pursuant to which Building Permit No .... 1.3. l. 3. .0 .Z ............ dated M a y I 6, 1984 was issued, and conforms to aR of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Addition to existing accessory building. The certificate is issued to JOHN BIELEWICZ ..................... ?o¥,;e;', Ye' gs~ ~g4jx ..................... of the aforesaid building. Suffolk County Department of Health Approval ............. .N/.A. ......................... N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION BATED: N/A Rev. 1/81 1~0u'M NO. 0 TOI/~H OF SOtJTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13130 Z Permission is hereby granted to: ,~ ,~ ~ ..~.o...,& ......... ~. ...... /..~../..d/~.~/~. . ~z.~...~....~.~....~.....~..~.~.~ · .... ~~Z.~g ........... ; ............................................. ~ ................. ~ ............................................. ............ ~ ........................ [..[; ............... [~ .............................................................. ~~....~.~ co~.. To× ~op No. :000 S.c,on ../..~.~/. ......... B,o~ ...0...5.. ......... Lot No...0.~:~ ...... pur~uont to application dat~l .... ,....---~ ................................ Building Inspector. · /,~ ~o ~/~ ~ ~ ~ Fee $ .Z c..~...~ ...... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTROLD 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 ~a ~ 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. Commercial buildings, Industrial buildings,. Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Enginber 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 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 code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy New Dwelling,$25.OO, Accessory ,$|0.00 Bus{ness $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years' $]0.00 4.Vacant Land C.O. $ 20.00 .upd ted c.o. $ 50. oo [ ate . . . :-. ./. ?. 7. ......... New C on s t r u c % i on Old or Pre-existing Building Vacant Land Location of Property . / ~O O . .'...~].~¢..c~,~2 ...C~.. . . .~..?~ .~.~. House No. Street Ham/et Owner or Owners of Property .................................... County Tax Map No. 1000 Section .... /.~..? ..... Block ..... ~ ''~ Lot ~ z/¥. Subdivision ' Filed Map No -T:q-; Lot No Permit No. . ./..o. .. Date of Permit . Applicant ....................... Health Dept. Approval ......... /~./~.. ......... Labor Dept. Approval ..... .~./.~.. ............ . Underwriters Approval ........ .~. J .~. ........ Planning Board Approval ....~./A .... . Flequest for Temporary Certificate Final Certificate ' .~. Fee Submitted $ /?.. ~ Constructio~n on above described building and ~jmit~applicable codes and regulations. Ap ,icant .... ............... FIELD INSPeCTiON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~DE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,Y. 11971 TEL. 765-1802 / 5/3o7 March 12, 1987 Mr. Bielewicz 1400 Wickham Ave. Mattituck, N.Y. 11952 Dear Mr. Bielewicz: unfortunately, I am not in the position to change or alter laws and codes to suit situations as they occur. ~ can understand your frustration, however, you must abide by the law. A c.o. (Cert- ificate of Occupancy), for the shed, can not be issued until an inspection is made on same. We do not mean to offer you any undue duress, however, we must apply the same regulations to your shed. Please contact my office at your earliest con- venience, so that we may successfully close your file. Victor G. Lessard VGL:hdv TOWN OF SOUTHOLD OF[qCE OF BUILDING INSPECTOR P.O. BOX 7:18 TOWN IIALL SOUTI'IOLD, N.Y. 11971 TEL. 765-1802 This is co advise ye. that the job under building permit no. 13130Z issued to John Bielewicz on __.~/16/84 for Accessory is completed a final inspection has ( ') ,h,as not ( x ) been done. , and fn order to complete tbi~ file, it iv necessary tha~ a Certificate of Occupaucy be issued. Please fill out the enc].osed form, return seme to the above office with a check for $10.OOpaynble to the Towu of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrnnge with this office for an inspection date Occupancy or use i.~ unlawful without a Certificate of Occupancy. l'len~e help us to clear up th~n matter no tbat legal action does not have to be taken. Thank you for yo~lr p~ompt attention. Vet! truly~, VictOr Le~sard E×ccu~ive Adminis~rator VL:gar enc 1 . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1803 Disapproved a/c ......... '.'. APPLICATION FOR BUIkDING PERMIT Application No .................. Date.. ?~..//.~. ........... INSTRUCTIONS a. This application must b; completely filled 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. 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 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 thc 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 necessaey, insl~.cti~ ~ e _A ............. ....of?cant, ornamCpacorp°ra!i°n) (Mailing address of applicant) State whether applicant is ~ lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises .~ *~ ................................................... d ' ' 6t (as on the 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 ....... .~..~.~.~. i f ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ...... l '4<'es o' - ~.q- .. /4 Pti... .~ ..... Hamlet House Number Street County Tax Map No. 1000 Section 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 ...O.l~/.~....v~.~t'f'~'~'".~.~f./?"~"~ .b. In tended use and occupancy .... /2~f~..- -~, .--r.--,,~.~~.. ~./.0.... ~../'St ~ q~.~ - .... 3. Nature of work (check wh,ch apphcable): New Building .......... Addition .......... Altera ....... Repa/r .............. RemoVal .............. Demolition .............. Other Work· .~ ....... (Description ' Fee · · · 4. Estimated Cost ...... i ......................... · .................................. I (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 ..... i ................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structureS, if any: Front ............... Rear .............. Depth .............. ,4~,ht . Number of Stones ................ . .............................. Dimensions of same structure with alterations or additmns Front ................................ Depth .................... 1'.. Height ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front ............... . Rear ............... Depth ............. Height ............... Numlber of Stories ...................................................... 9. Size of lot: Front ...........i ........... Rear ...................... Depth .................... 10. Date of Purchase ........... i .................. Name of Former Owner ........................... ' ' situated 11. Zone or use district in which premxses are ................................................... · ' oni g 1 dina regulation: 12. Does proposed constructionwolate any z n aw, or ncc or .............................. 13. Will lot be regraded .i. . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . .i ................. Address ................... Phone No..~.~. · · .~'ff..~ ..... ' Address Phone No Name of Architect .......... i .................................................... Name of Contractor i Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lin.es. Give street and block!number or description according to deed, and show street names and indicate whether interior Or corner 1(~ . . STATE OF.. NEW YORK, i: COUNT~ OF ..... , ...... . .....iS'S sJ ',ning contract) above named. being duly sworn, deposes and says that he is the applicant He is the ......................................................................................... (Contracfor, agent, corporate officer, etc.) of said owner or owners, and is d¢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 . [~ ~J~ day~f ~/~..~ ~ ............ Notary Public, ...... ~. ,~;..~.~.; .~.~... County' NOTARY PUBLIC State 0f New York ............................... lq0, 47075!8, 8ufl0]k C0unt~/.~