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HomeMy WebLinkAbout16208-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Zi8904 Date MARCH 19, 1990 THIS CERTIFIES that the building. ADDITION Location of Propert~ 4845 BREAKWATER ROAD MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 099 Block 02 Lot i8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, i987 pursuant to which Building Permit No. 16208Z dated JULY 2~ 1987 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING. The certificate is issued to WILLIAM DE LUCA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N060437 FEB. 27~ 1989 N/~ /Buil~n~ Inspector Rev. 1/81 lvOll~l[ NO, II 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) NO_ 16208 z Permission is hereby granted to: .~.~....~7~.!, ....................... ~ .......... ,o ~.~..~..~...~....~...~...~..~...~ .......... -~.'7:~' .......... 'r .......... , ......... at premises located at ...L~..~.....~.~..~:~:...,.......'~.~L .......... County Tax Map No. 1000 Section ...... ..~....~...~ ..... Block ...... ..~.....'~.. ...... Lot No....)....~. ............... pursuant 'o application dated ...... ~.~...~ .................. , 19.~..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 J~) ! FORM NO 6 P,0 ' --... Z/~ TOWN OF SOUTHOLD · ~fd~' 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 m ~ 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 Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZ~perty showing 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 certific__at~ - ~dditions~ $25.00 POOLS $25.00 C. ~ees: ~, 1. Certif[cateofpccupancy ~g $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 $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O.' $ 50.00 Date .......................... New C o n ;0 t r u c t, ~ o n ...... Old or Pre-ex isting Building ............ Vacant Land ............. Location of Property . .~. ?. ?..~, ..................................................... ... Owner or Owners of Property ............... ~- .9.9 County Tax Map No. 1000 Section .............. Block ............. Lot ................ Subdivision ................................. Filed Map No ........... Lot No ............... Permit No./.4d .~..~... Date of Permit ?. './(..~...~..Applicant . .~..~.]d.~...~... Health Dept. Approval .... "/~'4 ............... Labor Dept. Approval ...... ./(~./.~.'. ........... Underwriters Approval ./(~2/z'~ ~ Planning Board Approval ........... Request for Temporary Certificate ..................... Final Certificate ..... ~ ............. Fee Sub ntted $ '~.~..~."'~ Construction on above described building and permit meets all applicable codes and regulations, Applicant ............................................ Rev. 10-10-7fl THE NEW YORK BOARD OF FIRE UNDERWRITERS I BUREAU OF ELECTRICITY J--- i"~;J~J~[f~l'?/ ?/~ ~i~JOHN~: STREET, NEW YORK, NEW YORK 10038 ~ , ~, Date ~lpplication No. on file THIS CERTIFIES THAT ordy the electrical equipment os described belo~v and introduced by the applicant ~mmed on the above application number ir* the premises of OUT [] 2nd FI. Section Block and found to be in contpllance with the requirements of this Board. FIXTURE FIXTURES Lot RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS IMECLOCKS UNIT HEATEItS SYSTEMS NO. OF FRET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: A+ W G, NO OF HI-LEG A W. G+ NO OF NEUTRALS A W G. OF CC. CONO OF Ht-tEG OF NEUTRAI` Id'C, GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY ~FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE, MUST,, NOT[ BE ALTERED IN ANY MANNER. '0 UNDATION (1st) UNDATION ( 2nd ) UGH FRAME & FLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF $OUTLIOLD OFFICF. OF BUILDING INSPECTOR P.O.[lOX 1 179 TOWN IIALL SOUTIIOLD, N.Y. 11971 MARCH 21, 1989 TEL. 765-180,2 JOHN STEWART HOME IMP. P.O. BOX 521 MATTITUCK, NEW YORK 11952 R'E: WILLIAM DELUCA To Whom This May Concern, Pge are unable to complete you~ Certificate of Occupancy because .of the following reasons. /_-/ An application for Certificate of Occupancy is not on file. /--_/ No underwriters Certificate on file. RETURNED HEREWITH /.~_/ 'File chuck i:;(otltdatetl/~Y~X~Xd(f(x~]~%~X#550. PLEASE SUBMIT /~/ No Health Dept. Approval on file. NEW CHECK IN AMT OF $25.00 /-j/ NO final insDection has been made. P]ea:;e contact (our office on this matter. Thank you for your cooperation. ih~ildin(j PernlJ. t t~ I 6 2 0 8 Z Building Dopt. ***/_-/ tlc) Plumber uolder Certificate on file. ( all permitu involving plumbing being issued after Apri'! 1,1984 ) VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 5, 1990 Mr. William DeLuca 4845 Breakwater Road Mattituck, N.Y. 11952 Re: Building Permit ~16208-Z Premises: 4845 Breakwater Rd., Mattituck, N.Y. Suff. Co. Tax Map #1000-99-2-18 Dear Mr. DeLuca: During a review of our files it was noted that a Certificate of OccuDanc¥ has not been issued. According to the Code of the Town of Southold Article XXVIII 100-281 and 100-284 a building permit is needed for construction to an existing dwelling. It is unlawful to occupy a dwelling until a Certificate of Occupancy has been issued. Your final inspection has been made, and we have the Underwriters Certificate. Kindly send us your check in the amount of $25.00 and we will issue the Certificate of Occupancy. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Vincent R. Wieczorek, Ordinance Inspector VRW:gar TOWN OF SOUTHOLD BOARD OF HEALTH . 'FORM NO. 1 SURVEY .OF P./~...S TOWN OF SOUTHOLD CHECK - BUILDING DEPARTMENT SE?TIC FORM ............. : TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL ~,~ .~-.t/~-0- 7-~. ..... Examined . . .~. !..Z..., 19 .~. ·~ Approved..~. I .~.., 19~..~. Permit No. / .b.~.O..~..'~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of ptans, 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 publ/c 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 tins 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 sh~ll 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 necessary inspections. (Signature of applicant, or name, if a corporation) 6/ (Mailing address o f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ...Z'¢~....¢¢. ].~.~./.~../T....~. 1~ ~4 ¢'A ............................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......... /.,¢.O~".~z'.../.~_.~2.. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done~ ................................................. ............ ..... .............. .c ..... ............. House Number Street Hamlet County Tax Map No. 1000 Section ...~3~. ............. Block . .~.. ............. Lot.../...~. ........... pN ~ Subdivision ..................................... Filed Ma o ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .~..~.~.".-Pr)~....~.."}... ~.~M C~t~JC~. ' ;C' ;~' ) ~¢-"~'"-':~ .................... b. Intended use and occupancy ~. b~.~r~. ' .-~ ~,.-~ ~ 3. Nature of work (check which appllcable): New Building ..... ' ..... Addition . .~.~.'... A!.terati.on .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost Fee ~ 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 ~ 6. If business, commercial or mixed qccupancy, specify nature and extent of each type of use ' " 7. Dimensions of existing structures, if any Front ........... ~.... Rear .......... ,... Depth ............... Height ............... Numbe~ of Stories . .. 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 Numb~ r of Stories ' e~ar D pth 9. Size of lot: Front ............. ~ ......... R .~.:.'.:.'... e ...................... 10. Date of Purchase ............. 1 ................ Name of Former Owner ............................. 11. Zone or use district in which prem ises are situated ..................................................... 12. Does proposed constructio~n violat~ any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........... I ................. Will excess fill be removed from premises: Yes No 14. Nmne of Owner of premises ..... : ............... Address .................. Phone No ................ Name of Architect ' Address Phone No Name of Contractor ........... i ............... Address ................... Phone No ................ 1.5. Is th±s property located w±ith±n 300 feet of a t±dal x*etland? *Yes ..... No ..... *If yes, $outhold Town Trusi:lees ?erm±t maybe retlu±rad. I PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether , interior or corner lot. COUNTY OF ~..'w °", ........... ~..~../~.. ~/. ~..~..~A~..~../~.?. 7 ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. :lc is the ' i (Contractor, agent, corporate officer, etc.) ')f said owner or owners, and is duly authorized to perform or have performed the said 'work and to make and file this ~pphcatmn that all statements ontatn~d m th~s apphcat~on are true to the best of his knowledge and belief; and that the ~ork will be performed m the manner set forth an the application filed therewith. before me this .day o~'.'. 19 .~. 7 ~worn to qotary Public, ,. t$~ County (Signature of applicant)