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HomeMy WebLinkAbout13171-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18420 Date SEPTEMBER 26~ 1989 THIS CERTIFIES that the building Location of Property 16105 MAIN ROAD House No. County Tax Map No. 1000 Section 115 Subdivision ACCESSORY Street Block Filed Map No. MATTITUCK, N.Y. Hamlet~ Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25~ 1984 pursuant to which Building Permit No. 13171-Z dated MAY 31~ 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 ACCESSORY 3 CAR GARAGE AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. l/B1 JOHN M. & JANET J. STEWART N/A H-005627 - OCTOBER 6t 1988 [ Building Inspector FOB]M[ NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13171 Z Permission is hereby gronteRI to;. ~ -~ . - ....~....~.~.~..~...~~... .... ~..~...~ ................................................ .... ~.~..~.:~.:..../../...~..~....~...... ,o ...~.~.....~........~.~....~....~.~...~..~.~ ............ ~'"'"~""~'--'"'~. ....... w~ ......... :'""~'"7 ....... ~':~'""~:T .................... I ~olo~ ~ . .gl, ...... ~'~. at prem,ses located at .............................. '["~Jr .... ~' ........... 'r"/'"~ ~ ..................... County TOX Map No. 1000 Section ....... ~..~...~.: ...... Block I Lot No. '~ I~uildlng Inspector. F~,.a.~..:~.S .... and approved by the Rev. 6/30/B0 FORM NO. TONN OF SOUTHOLD BUILDING DEPARTMENT TONN UALL 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be filed in typewriter OR ink and submitted to the Building Inspector 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). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less than 2/I0 of IZ lead. 5. Commercial buildings, industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the 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: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire Iot prior to April 9, 1957. . If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: i. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire 10t prior to April 9, 1957 shall also accompany the application., If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. FEES: ~. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2, Certificate of Occupancy on pre-existing dwelling - $]00.00. 3. Copy of Certificate of Occupancy - $5.00 - over $ years - $I0.00 4, Vacant Land Certificate of Occupancy - $20.00 5, Updated Certificate of Occupancy - $50.00 6, Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial rev' 70/14/88 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ..... fOLD OR PRE-EXISTING BUILDING ..VACANT LAND ~ocation of ProperW .... Z$JA~..; ..... ~.~.~. ..... /Y~.~7.~z~._.~ ~/... HOUSE NO. HAMLET / Owner or Owners of County Tax Hap No. Subdivision ............. I~1 7/ ~. D t Permit No ......... a Health Dept. Approval ''' ............... Underwriters Planning Board Approval Request for Temporary Certificate ....... Final Certificate Fee Submitted: I STREET Property.. ']~''~' .... V~. . ,ooo Se=tion l/~E~oe~ ...i. ~ot' ..2' ..... ......... Filed Map ........ Loc .......... of Permit .......... Applicant Approval .............. co%:l~qan rev. ]0/]4/88 TOgrN OF $OUTLIOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 1179 TOWN IIALL $oU'rlIOLD, N.Y. 11971 September 21, 1989 TEL. 765-1802 JORN H. & JANET J. STEWART 16105 MAIN ROAD MATTIlllCK, R.¥. 11952 To Whom %hzs May Concern, We are unable r.o complete your Certificate of Occupancy because .of the following reasons. /_--//An application for Certificate of Occupancy --A/-A is not on file. (.ENCLOSED) /~/// No Underwriters Certzficate On file. /~// The cheek i'.; (o~u~JJfl~Kot on f/lc. ) $25.00 /.~/ No Heal. th Dept. Approval on file. /--/ No final insDection has been made. Please contact our office on this matter. Thank you for your cooperation. lhlkldkr',g Permit }} I 3 I ? I Z Dui ld (hq Dept. *'**/~/ ~Io Plumber solder Certificate on file. ( all permits involvitig plumbing being issued after April 1,1984 ) TOWN OF $OUTHOLD OFFICI'~ OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTIIOLD. N.Y. 11971 TEL. 765d8o2 'rh i ,~:, is permit no; ,,,, /,a, L8.4 a f i n a 1 to advise y:ou that the job under building t3171Z issued to John Stewart ii : .... for A~cessory ' ts completed iO,;pectioa ha:; (-----7--l~-~a-s' n~been done. and rn older to cqmplcte this f:ilc, it is necessary that ;t Certlfigate of 0c. ct panty be issued. Plean~ fllt Out !thai enclosed for.m, return same to tile above office with a dheek for $10.00 p'aynble to the Town of Sou(hold..~ Please indicate to Whom the Certificate of Occup'ancy is tO be mailed, 4nd arrange w~tb this office for an iiDspection (late 0ccnl)ancy or uae in unlawful w{thout :a Certif{cat6 of Occupancy legal act Plea~e.',help ils to ~.on does not have to yon for yuur prompt Than el'ear up this matter so that be taken. attention. Victor Lessard gxecutive Administrator VL: ga r ('11£ ] . ~-' i E I,D '[;ISPECTiOI~ FCU Ut) A'? foil ( 2nd ) [:}lAME & PLUHBING 3. STATE C,ODE q. A D D I '[";. OH A L COHHF 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ]INSULATION FRAMING [ ~FINAL /~ 765-S802 BUILDING DEPT. INSPECTION FOUNDATION SST FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION [ ~l~L DATE // 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N,Y. 11971 TEL.: 765-1803 ...~..~.1.. 19 .~.5' Examined .., Approved . . .~...~..~./.., 19~..ti. Permit No./..~.! .7.]. ..~.. Disapproved a/c ..................................... ....... i~~;it;;~' ' ' ................................. ...... .. APPLICATION FOR BUILDING PERMIT Date ............. i . 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 properW 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 regulations, and to admit authorized inspectors on premises and in building for ne~nspect~_~ ~--.,-.~ -~.~~x-.~~%. ~C~........'-'-'"~""-"~'[ ,~t~u/ . (Signature of-l~t, or name, if a co}poration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ....................................... ~ 21 .................... : ........................ Nameofownerofpremises ..~.XYklO ..~....~....~.~...~.....~..~."~'"..~...~.. ................. (as on the tax roll or latest deed) If a~ant is a corporation, signature of duly authorized officer. ..... (Name and title of c'm!cmdate offi ) Builder's License No .... ~.'.~ .............. Plumber's LicenSe No ..... .~..O..~___~. .......... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done....~. ~w¥~-., ....... .../. ~./. ?..¥ ......... ~ ..................................... House Number Street Hamlet "-" ...... ]. ....... Lot .... ~ I r.x County Tax Map No. 1000 Section ...... ,. ,.~-~. ....... Block ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................... b. Intended use and occupancy ............ .~..0~,..e~....~. (~.Ox...C~, ........ (?...u,)~ .................. 3. Nature of work (check which abplicable): New Building ....~.' ..... Addition .......... Alteration .......... Repair .............. Rembval .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ........... ................... .... .. Fee ...................................... '" (to be paid on filing this application) 5. Ifdweiling, number of dwelling units~ ............... Number of dwelling units on each floor ............... . If garage, number of cars ............ ~ .~.~..~ ...~5:~..C~.. ....................................... 6. If business, commerciai or mixeld occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurgs, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front Rear ................ Depth ' Height Number of Stories 8, Dimensions of entire new consti~ction: Front .. .~,, ........ Rear ,.. :'Ok ........ Depth , ,;g,Q' .......... Height Number of Stories \ .%~r~x~ 9. Size of lot: Front ..................... Rear ...................... Depth ...................... 10. Date of Purchase ............................ Name of Former Owner ............................. 11. Zone or use district in which premises are situated ......... .~~ ................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... .~;2~ ....................... 13. Will lot be regraded ...... k)~ ................... Will ex~ess fill be removed from premises: Yes (~ 14. Name of Owner of premises 5~-~O...~...~e~..... Address .~_'~ .O.~.~-!~.~... Phone No ................ Name of Architect . .~~ .~;9~,4C~... Address . [ .~qg,.~'..1~..~.\~.~.. Phone No.. ~ .~.~\\ .... Name of Contractor ~ Address Phone No PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, C OUNT._Y~OF ................. ..... .%.4-.LJ~..-w. L:f,.X.~5'q&g~.~DlO.~.~eing duly sworn, deposes and says that he is the applicant (Name of individua-T~gn~ng contract) above named. He is the ..................... i ......................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 No. 4707878, ~uff0 k C0un}y ( TSi~aature of applicant) d, ~PP[~Ot'CD ~S NOTED 7~-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNnATION - TWO REQLJtRED FOR POURED CONCRETE 2. ROUGH ~ FRAMING & PLUMBING 3. INSULATION ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N, Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS.