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Home My WebLink About13144-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22685 Date OCTOBER 29~ 1993 THIS CERTIFIES that the building. STRUCTURES Location of Property 3525 COUNTY ROAD #48 House No. Street County Tax Map No. 1000 Section 141 Block 2 Subdivision Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 21.4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/11/66 & 5/16/84 pursuant to which Building Permit No. 3183Z & 13144Z dated 8/11/66 & 5/19/84 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 RELIGIOUS CHURCH BUILDING & MODULAR BUILDING TO REPLACE EXISTING BURNED DWELLING AS APPLIED FOR * The certificate is issued to ROBERT HAMILTON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NOV. 11~ 1966- R. Villa UNDERWRITERS CERTIFICATE NO. N-716544 - Nov. 11~ 1985 PLUMBERS CERTIFICATION DATED N/A *THIS UPDATED CO Z-2711 dated 5/16/67 & CO Z-20307 dated 10/28/91 /~Building Inspector Rev. 1/81 FO]g~ NO. ~ TOWN OF SOUTHOLD 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? 13~44 Z Permission is hereby .... granted : , ~.~2~i~ ~ "~- ........................ ..................................... at premises I~ated at .................. .~,.[;~ .......... ~.~..(~a~.r~w ........................................ County Tax Map No. 1000 Section ..... ]...~..[ ........... Block ........ ~ ........ Lot No. ........ ..~..~.CL ........ l..~.. ..................... , ,9~..C.l.., and approved by the pursuant to application dated .... Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20307 Date OCTOBER 28~ 1991 THIS CERTIFIES that the building D~ELLING Location of Property 3675 COUNTY ROAD #48 MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 141 Block 2 Lot 21.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16~ 1984 pursuant to which Building Permit No. 13144-Z dated MAY 19~ 1984 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 MODULAR BUILDING TO REPLACE EXISTING BURNED The certificate is issued to DWELLING AS APPLIED FOR. NORTHEASTERN BIBLE COLLEGE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-716544 - NOVEMBER 1I, PLUMBERS CERTIFICATION DATED N/A 1985 ' -~uilding In~p~c%0r ' ' 3 Rev. 1/81 Form No. 6 , ~PLZCATION FOR CERTIFICATE OF OCCUPANCY TOWIq OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL ~65-1802 This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: i. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. .. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ~ ~ "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and ' unusual natural or topographic features. ~ 2. A properly completed application and a consent to inspect signed by the applicant. If ~ Certificate of Occupancy is denied, the Building Inspector shall state the rea'sons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . QD~Pb9T :;ew Construction ........... Old Or Pre-existing Building .............. Location of Property....3.5~..~ .~QI~ .l~Q4~..~ .......... ~%%~C~,. ~..~ .......... House No. Street Hamlet Onwar or Owners of Property ROBERT .~ILTQN County Tax Map No i000, Section .... [~[ ....... Block .... ! .......... Lot... Subdivision ................................. /~led Map ............ Lot ............... ....... Permit No 13144-Z iDate Of Permit 5/16/84 ............... · · · Applicant Uealth Dept. Approval .......................... Underwriters Approval ......................... a~]nlng Board Approval .......... ' .............. Request for: Temporary Certificate ......... Final Certicate ........... 'ce Submitted: $ .... 50.00 ~DA~D CO ~PLIC~T Building Department Town Ha I Southold, N.Y. 11(371 765 - 1802 APPLICATION FOR CERTIFICATE OF instructions A. ~This application m.ust bo filled in ..t?.p. ewrtter OR ink, and submitted ~ mJJ==,=~ to the Buildin~j Inspec. 'Jar 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 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 instafla. lions, a certificate of Code compliance from tho Architect 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 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- tion required to prepare a certificate. C. Fees: . 1. Certificate of occupancy New Dwelt~ng..$25.00, Acce.~aory ..$10.00 gun,ne,; 2. Certificate 0f occupancy on prmexisting dwelling 8 50.00 3. Copy of cortificate of occupancy $ 5.'00, ove~ 5 yea~s ~10.00 4.Vacant Land C.O. $ 20.00 ~' ~' --'' 5.U~dated C.O. $ 50.00 Date .......................... 6. hlteration $25.00 New C on s b P u c [ i o n ...... Old or Pre-existing Building ............ Vacant Land Locndon of Property ................................................................... ItOU~ ~o. Sfreet Ha,ale Owner or Owners of Property ................................................... 141 2 21.2 County Tax Map No. 1000 Section .............. Block ............... Lot ................ · ' ' Flied Map No Lot No Subdivision .......................................................... Permit No ........... uate et ~erm{~.. ....... f,.. )~ , ·., ................................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Planning Board Approval Underwriters Approval .............................................. Request for Temporary Certificate Final Certificate · Fee Submitted $ Construction on above described buildin~it~ects a~licable codes and regulations. Aoplic ........ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8B JOHN STREET, NEW ~YORK, NEW ~ORK 10038 THIS CERTIFIES THAT in thefollowittg location; ~ Basement ~ 1st FI. ~ 2nd Fl. Section Block Lot ~OV~)~ ~4t ~[9~5 andfound, to be ln compliance with the r~quirements of this Board, FIXTURE OUTLETS DRYERS IECEPTACLES SWITCHES FIXTURES RANGES OVENS EXHAUST FANS NCANDE$CENT FLUORESCENT 5 FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO, ~F FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V I .o. %~,c?o.o. ,~. w.o. NO o~ ~,-~o I OF CC COND. OF HI-LEG NO. O~ NEUTRALS AW, G, OF NEUTRAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto UILDING DEPARTM GENEI~AL MANAGER / Per ~ may be identified by their credentials. I ANY MANNER. ~"I F, LD .i H S~gC'i'iON EOU~JDATIOH (1si,) FOUHDAT IOU 2. ( 2n d ) PLUMBING 7USULATION PER ~. S'~ATE ENERGY C,ODE FINAL TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR I'.0. BOX 728 TOWN ItALL SOUTIlOLD, N.Y. 11971 TEL. 765-1802 This ia to advise you that the job under building permit no. ~3!.44Z__ issued to North Fork Baptist Church aa ___~/!6_~4~__ for Ne~w_Dw~lling, is completed a final inspection has ( ) has not ( x) been done. and In order to complete this file, it is necessary that ;i Certificate of Occupancy be issued. Please fill out the cnc]osed form, return same to the above office with a cheek for $25.00paynblc to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use ia unlawful without a Certificate of Occnpnncy. Please help ns to clear up this matter so that legal action does sot have to be taken. Thank yon for yonr prompt attention. Very truly ~, Victor Leseard Executive Administrator VL:gnr encl. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined.. .... ,19 !I. ' Approved. · .~.~.. ).~.., 19 ~.~. Permit No. I .~}.9.~ ~ Disapproved a/c ..................................... ................................ ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. INSTRUCTIONS a. This application must be 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 ~ving a detailed description of layout of property must be drawn on the dia~am 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 inspe~cti, o~s. · (Signaturg of applicant, o¥ name, if a corporation) .... : .... i.. ........... (Mailing addrdss of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ...~ ..... ~.e.~ ........................... : ........................... Name of owner of premises ~ ~ ~. a~ -~. · '~ '~'~' '~'3~' ' C~'~~ ....................... · ' ' (as o~the tax roll or latest de d If ap,~ant is a co~o[~on~ signature of duly authorized officer. · .... Builder's License No. · t-~ O.~ IO.. CO~-P.ff~D.. '~I.x-C~C'I '0 I0 Plumber's License No..l(kl~ .~... Electrician's License No..~TT~.~-..~1..~. · · · '~ ~' 'L'~-'7 Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ................... .... .................. ........... Honse Number Street Hamlet C;unty Tax Map No. 1000 Section .... I..~...~ ......... Block .. ~...~m-. ........... Lot .J ~ J7.'.1.¥.~.1.~.'..Z-.I. - ~ Lot Subdivision . . ~.O. ~.. ~ ....................... Filed Map No .............................. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: N mber ofd elling units on each floor 5. If dwelling, number of dwelling ~nits ............... u w - ............ If garage be of ears ........ , hum r ..... i ..................................................... 6. If' business, commercial or mixed occupancy, specify nature and extent of each type of use ......... // ...... 7. Dimensions of existing structurei, if any: Front .... ~d[9. ...... Rear .Q-'~.O .......... Depth . ,X. ~.. ...... Iqeight ............... Number of Stories '. ....................................... ' '; alt rations r additions: Font R Dimensions of same structure with. e o r ................. ear ........... · · · ' Height Number of Stories Depth 8 Dimensions of entire new construction: Front ............... Rear ............... Depth ........... Height ............... Number of Stories .................................................... Nature of work (check which applicable): New Building .......... Addition ........ Alteration .......... R psi Removal ............ Demolition .............. Other Work ............... "- cription) e r ...... ',1 ....... ~ (Des maledCost.~. ~710~...'' Fe O Est i ................. ~n filing this application) . (to be paid 9. Size of lot: Front ........... i ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... i .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... .,.I...i~. ~ ..q. · t _..t ........ Will ~;~ess fill ~e r&moved from premises: Yes No 14. Name of Owner of premisesl.~l~x~.~0~.~' ...... A. d,d. res{~(~1'~,~l~?:..U,/., .... ~; I~;' : ............. Name of Architect ......... i .............. Auuress ............................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al. buildings, whether existing or proposed, and, indicate all set-bask dimensions from property lines. Give street and blocg .number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~ORI~../ ..... ~:.-~. ~,~f~..~ ................. being duly sworn, deposes and says that he is the applicant (Name of individual si~ning contract) above named. I (ContraCtor, agent, corporate officer, etc.) of said owner or owners, and is dhly 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 m the application filed therewith. Sworn to before me this , ~ ~ 8~.'~~.'~'~ (Signature of applicant)~