The URL can be used to link to this page

Home My WebLink About13219-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z17051 Date July 1, t988 THIS CERTIFIES that tbe building ...... D..e .o.k.. a..d .d.i.t. ~..o .n ........................... Location of Pro ert 265 Freeman Road Mattituck House No. Street Ham/et County Tax Map No. 1000 Section . . .1.3. ? ...... Block 03 .Lot 037 Subdivision. 9.a.r.d..e.n. fi.e..~.g.h.t.s. ............. Filed Map No ......... Lot No.43. 7.~? ......... conforms snbstantially to the Application for Building Permit heretofore filed in this office dated ....J.u.n.e...12, 1984 pursuant to whicb Building Permit No. 132 9Z dated .... .J.u.n.e...1.3. ,.. ! .9.8.4. ........ was issued, and conforms to all of the requirements of the applicable provisions of the law. Tile occupancy for which this certificate is issued is ......... Deck addition to existing one family dwelling. . .................. The certificate is issued toKEITH HARRIS ..................... ?o'~;.;;,'ai~l/~/~i~' ..................... of the aforesaid building. Suffolk County Department of Health Approva[ N/A UNDERWRITERS CERTIFICATE NO ............... .N./.A. ............................... PLUMBERS CERTIFICATION BATED: ........... Bnilding Inspector Rev. 1/81 ffO~ NO. D TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLE'rlON OF THE WORK AUTHORIZED) N? 13219 Z Permission is hereby granted to: ............ L-~:,..~.-z.....A/../..,~..~.~..~: .............. .......... ....~...~....o.... .......... ~.~.~ ...... ~Tz~ ....... ......... Z~.~.~.~...~..~..~..cZ~.~......./~......~....z.z..?~a" ,o ...... ~.~~. ...... ~:~....~..~.~...~~....'~ ....... ~..~..,~.~ ................................................................................................................. at premises I~at~ at ...~.~ ........ ~~~.....~ .................. ............................................................................................................ ..... ~~.~/~z~.~ ............................................................. co~ ~ ~a~ ~o. ~000 Se~.on ...Z~. ........ ~ ...~.~ ......... ~o~ ~o..~.~ ........ Building Inspector. Fee $_4~..~...." ........ Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Noz17052 Date ...J.g.L.y. 1, t988 THIS CERTIFIES th t th b ildi Pool a e u ng ................................................ Location of Property 265 Freeman Road Matt i tuck House No. Street Hamlet County Tax Map No. ! 000 Section . . .1.3.9 ....... Block .0. 3. ............ Lot ...... 0. 3. .7 ........ Subdivision... ~.a.r.d~e..n..H.q $ g.h.t.s. ........... Filed Map No ......... Lot No..~.3. T~.~ ....... conforms substautially to the Application for Building Permit heretofore filed in this office dated ·..a..u..n.e.. 1.2.,..1.9.8. ~.... pursuant to which Building Permit No..1.3.2. 1. 9..Z .............. dated June 13, ' 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 ......... ·..A.b 9y.e.. g Tp.u.q .d.p.qq 1:..a.n.d...dg.c.k': ............................................. The certificate is issued to KEITH HARRIS ..................... /o¥,;~;.~~!~x .................... of the aforesaid building. Suffolk County Department of Health Approvai ....... !,J. [ .A ................................ UNDERWRITERS CERTIFICATE NO ............... ~..6 .5.6. 2. 0. 9. ?..g: .2.2. ,...l ?.8.4. ........... PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY SEP f 8 Instructions A. This application must be filled in typewriter OR ink, and submitted ,,, ~ 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 s~nilar buildings and installa- tions, a certificate of Code compliance from the 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 unusum 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 occupancv 2. Certificate of occupancy on pre~x~ting dwelling 3. Copy of certificate of occupancy'~ '~ $1.00 4.Vacant Land C.O. 5. Updated C.O. $15~0~ Date ..................... New Building ............ ,~OId or Pre-existing Building ............ Vacant Land ............. Location of Property /~.~,. ..... ~-'i'e.zTO .qfg.· ......'/~ ./~. ~. .. ,... .. House IVo, Street Hamlet Owner or Owners of Property .... / ............................................. County Tax Map No. 1000 Section .../.~..~. ...... Block ...... ~. J. .... Lot ..... .~...~...~.... Subdivision....~. (.~'..~.~;~.(/.../~f.O~/,/~.~..Filed Map No: : ......... Lot No... ?/..--~..'~...~/.~.. Permit No. ~,~.~ ,~,,~. Date of Permit,~,/~,~.,' .Applicant...K~..I. ,~,g ,. .c, ...... Health Dept. Approval ........................ Labor Dept, Approval ........................ A~ /¢,~c~ ¢).~ g B App Underwriters Approval .................... Plannin oard royal ...................... Request for Temporarv Certificate ..................... Final Certificate ....................... , Fee Submitted $ ..................... Construction on above described building and permit meets a_ll applicable codes and regulations. 3 ¢ o z / 7orl THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000771 J~-~b BUREAU OF ELECTRICITy 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~ll~lY~I; '~' ~ THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the abdve applicu[ion number in the premlses of Keith ~hrr_i:,,, N/S i~-e~umu i;'~d~., 300~ E/O Wlckh~m Ave., ~attituc, k, in the following location; [] Basement [] 1st Fl. was examined on ~l~3~L ~J~ FIXTURE !RECEPTACLE! OUTLETS DRYERS FURNACE MOTORS FIXTURES [] 2nd FI. Ok~ld~ Section Block and found to be in compliance with the requirements of this Board. FUTURE APPLIANCE FEEDERS OTHER APPARATUS: 1-G. F. C. I. RANGE fPECIALREC'PT S NO OF CC COND A W.G. NO. OF H-EG / PER ~ OF CC COND ~ LOt UNIT HEATERS MULTI-OUTLE1 SYSTEMS NO. OF FEET C E 'A. W, G NO. OF NEUTRALS O~ HI-LEG (~'~m~ng Pool) This certi:~lcate covers ca~pli~nae at the d~te oZ inspection only, ~k~c~se of '~]~al envi~nents :It i~ advis~le to have frequent test ~d/or r~p~rs m~la by a qualJ.2i~ perso~. EXHAUST FAN¢; DIMMERS OF NEUTRAL P.O~ Box 143~ ~ttJ. tuck N Y ] 19'52 * ~ ~ ........ .... ~-~; ~ GENERAL MANAGER this certificate must not be altered in any manner; return to the office ~' *~ ........ Pe~ ~ VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O. Box 1179 Southotd, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD June 15, 1988 Kathleen Harris 265 Freeman Rd. Mattituck, N.Y. 11952 Dear Mrs. Harris: On 6/I/88 our inspector and gave his approval for occupancy to be issued. The check that was in your Please send us a new one. $35.o0. znspected your pool a certificate of ~ folder is outdated. The amount due is Yours truly, Secretary TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under the building permit no. 13219Z for Addition &zAlteration is completed. A final inspection made on 9/24/86 showed that the gate needed repairs since you building permit expired on 12/13/85 it is necessary that you obtain your CO.e If the problem has been corrected, please contact this office to set up a time for re-inspection. { We are returning your check because it is out- dated. Kindly forward us a new check in the~ mmount~ Of $ 35.00 for the Certificate of Occupancy. Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this<matter so that legal action does not have to be taken. Thank you for your prompt attentio, n. Very truly yours, Victor Lessard ~w~,~,,~ i v~ Administrator KEITH HARRIS & 3 9 KATHLEEN HARR,~ ~1 ~ P.O, BOX 513 MATTITUCK, NY 11952 9 ~ ~-79"214 B~&~srCa FI~LD ~NSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) }{OUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C~pDE FINAL ADDITIONAL COMMENT ~. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION lIST [ ] ROUGH PLBG. [ ] FOUNDATION ZNO [ ] INSULATION DATE , , , INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION REMARKS: ~~ ~ ~ /~1 ' DATE 765-1802 BUILDING DEPT. SPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ::)ND [ ] INSULATION 2'65-1802 BUILDING DEPT. INSPECTION FOUNDATION ~,ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS:~ 3¥ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c . ..~ .......... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 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 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 shal! be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been grantqd by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Departme~nt 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 necessa~)nspe~ccti~ns, kA_ k (Signature of-applicant, or name, if a corporation) · (Mailing a~ldress of applicant) / / e/fro'l- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... t-'k ......... ..... ............................................... Name of owner of premises .. ~, ....... t~ ie'~. t. ~ ................................................. (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 .~-.! .Tr.. ............... Plumber's License No ......................... Electrician's License No../~.~.(.-2t~..~.. Other Trade's License No ...................... 1. Location of land on which proposed work will be done ........... .~.~...t~..q .Q ....... q ................ House Number Street Hamlet County Tax Map No 1000 Sectio~ /.~ . Block ...~.~ ........... Lot.. ~.;7. .......... Filed Map No ............... Lot .~ .... ~. .... (Nam6) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ..... ~ ....................................... b. Intended use and occupancy ... 5~ ........................ 3. Nature of work (check which appl/cable): New Building . .q::'~ .. '.. '~ddition .......... Adteration., ......... Repair .............. Rem val .............. Demolition ........... Other Wot 4. Estimated Cost ............ ~ ........................ Fe .... ] ',~,/ '~' (to be paid on filing this application) 5. If dwelling, number of dwelling ~3nits .· · ¢. ~'.'~.-~ f..... 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. Dimensions of existing structure~, if any: Front ..... ~. ~ ....... Rear ...,.~.. ~ ...... Depth . .e~gv~. ........ Height ............... Number of Stories ..... et ~.~, ..................................... ........ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... ].. Height ...................... Number of Stories ...................... 8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front .... ZOO.. ~.~ ......... Rear .... /~.O...A'.~ .......... Depth ...................... Date of Purchase . ./.~.~. 9..~..id'~. ~.q ............ Name of Former Owner ............................. Zone or use district in which pr~mises are situated ..................................................... Does proposed construction violateany zoning law, ordi~_a.~?~ ~ulation: ..... ~.~9 ........................ Will lot be regradeO ..... }t~..,.(~.S~'.I~,,. ~.. ~I~.. ~,~i exces~'~fll be removed fr~lm premises: ~es . Name of Owner of premises . .tff0t~Pl. .... ~tt'~.t~ Address O~.~,tgw,~!g~...~-~..~.~. Phone No. ~...~,,~,~... Name of Architect .......... i ................. Address ................... Phone No ................ 'Name of Contractor ......... ! ................. Address ................... Phone No .............. 10. 11. 13. 14. , PLOT DIAGRAM Locate clearly and distinctly alii buildings, propel~y lines. Give street and block interior or corner lot. STATE OF NEW YORK, COUNTY OF..-.~. ~'J'.~i~ ..... whether existing or proposed, and. indicate all set-back dimensions from xumber or description according to deed, and show street names and indicate whether ..... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................... ! ................................................................... i (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 ............... t.~....~...' .day ofi .... . ~/~4~. ......... 19 .?~ .... ,[tm ~. ~[ v0~ ........................ N0fARY PLIBLIC, Stat0 0fNew York (Signature of applicant) No. 4707878, $offo{k ¢0unt2( Term Exr)~res garch 3!, I~,,~Y_~