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Home My WebLink About16219-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha~i Southold, N.Yo CERTIFICATE OF OCCUPANCY No Z18190 Date JULY 17~ 1989 THIS CERTIFIES that the building Location of Propert~ 1855 House No. County Tax Map No. 1000 Section Subdivision ADDITION MEDAY AVENUE MATTI~JCK Street Hamlet 113 Block 9 Lot 8.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 8, 1987 pursuant to which Building Permit No. 16219Z dated JULY 13~ 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 ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to WILLIAM & DIANA WALTERS (owner, YJ{Y~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N786505 & PENDING Building Inspector Rev. 1/81 FOR. BE NO. ft TOWN OF $OUTHOLD 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- 16219 z Permission is hereby granted to: ........... ....~.~.~...I...~..L ................................................... at premises' ' ~ ' '' ',ocate~l at ..... .~...~.~........~.~.._.k,~...,..........~.~ County Tax Map No. 1000 Section ....... ).L~,~ ......... Block ......... ,.~...~ ..... Lot No...~......~..:.~ pursuant to application dated .......... ...~....~...~ ..................... , 19..~..~/.., and approved by the Building Inspector. Fee $....~'"~...:..'...'~... ..... Building Inspector Rev. 6/30/80 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING..' -VACANT LAND ........ Lo~ie, o~ P~op~r, ..... /.~.~.:~. . : ..... .'.~d.~. . .~.~.~. ~.~ J/~/,~.~.~ HOUSE NO. STREET ....... HAMLET Owner or Owners of Property.. Eoon=y T~ ~ap No. '000 See~io~ .././.& Subdivision ....................... Filed Map ........ Lot .......... ~"0./ ~. ...... Date of Per~iE .......... Applica°t o . Depc. Approval ......... ......... Underwriters Approval ......... Permit Health Planning Board Approval ................ Request for Temporary Certificate ....... Fee Submitted: $ ...... .~, -.. Final Certificate APPLICANT. rev. 10/,4/88 ~°=~adsuI ~u!pI!nH oq~ 'pazuop s! X~uedn~oo ~o o3ev}~!~aoD e ~I 'u°x~e~!Idde a ~uedmo3oe osie iluqsl ZgG[ '6 - I!adv o~ ao~ad ~0I aa!~ua aq~ ~o d!qsaoumo pue ainu,s ~u!~oqs! &uedmo~ ai~!~ e &q pan~sz oi~ ~o ~oe~sqe pa!~o~ e pue 'pa~!mqns oq i~eqs ~ouudn~o0 go o3eo!g!~aoD PUei ~uemeA aog uo~eo~idde uV .! :~vuodnovo ~o a~eo!j~aoD pue~ ~ue~eA ~o~ aoq~o ao '~os~moad ~o s~u~pl~nq ~o uo~od~u~ X~o~o~ ao opoo ~U~noq Xue ~o o~a -£ oqa oaea~ ileqs =oaaadsuI ~u~pi~nH oqa ;po!uap az <oUe~n~vO ' Ileqs qa~qaiXuedmoo oI~3 e ~q pons~ oI~ go ~oe~sqe pa~aao e pue 3uev~idde oq3 &q pauWz~ 3oadsu~ o~ ~uoguov e 'uo!~e~!idde pa~oidmo~ Xiaadoa~ V '~ 'saan~eog o!qdea~odo3 lo ieln~nu ien~nun pun s2u!pi~nq 's~o~3s 'sau~i X~aadoad lie 2u~oqs ~aado~d ~o /an~ns o~eauomV 'I 's~uo~a~nba~ uoid a3~s pa3oidmov Jo IeAoaddv p~eoff 2u~uuel~ ~]mqns '9 '$u~pi~nq oq~ ao~ aIqzsuodsa~ aoauz2u3 ao a o~ ~i ~zaa ~aq~id mo~ ~uama~3s Uao~S '9 ssaI suzeau°~s u z '(mo& 6-S)iusods}p_p~oaoaos pue &Iddnm ao3em ~o '~do~ q~ieOH go ieAoaddo ieu!M .g 's~u!I ~=odoad 's~u!p~!nq iie 3o uo!~eooI o~eanooe q~!m Z~adoad ~0 ~a~ns Ieu!A '1 ~u!PI~na oq~ o~ po~}mqus puc Mu~ MO ao~!~odi~ u! poi!~ oq ~snm uo!~}iddv -¥ ZOS! - £9£ O'IOILIJIOS .~0 NMOg 9 ' ON tC60A SEPARATE I~PPLICAllON M~ST BE FI~ED FOR EACH SEPARAF~ BUILDING TO VN OF $OUTtlOLD OFPlCE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 TEL. 765-1802 June 27, 1989 To Whom This May Concern, We are unable r.o complete your Certificate of Occupancy because ,of the following reasons. /x_--~ An application for Certificate of Occupancy is not on file. ENCLOSED /~X No Underwriters Certificate on file. /~ The check i:;(outdated/n_~_t__o_l_l_.~i~e_.i- $25.00 /_-/ No Ileal. th Dept. Approval on file. /~/ No final inspection has been made. P]ea:;e contact our office on this matter. Thank you for your cooperation. Ihtildinrj Permit # I 6 2 I 9 Z ADDITION Buildin9 Dept. *'~*/_--/ Ho Plumbar .'3older Certificate on file. ( all permits involving plumbincJ being issued after April 1,1984 SENT TO: WILLIAM WALTERS BOX 18 l MATTITUCK, N.Y. 11952 OU~DATION I 2nd ) OUGH FRAME & PLUMBING f:;SULATION FER N. Y. STATE ENERGY CODE FILIAL ADDITtONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. iFRAFOUNDATION 2ND[ ] INSULATION MING [ ] FINAL ~NSPECTOR ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~J~'~LATION FRAMING [ ] FINAL REMARKS: 765-1802 BUILDING DEPT, INSPECTION I' .F'FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL / / ~.~ DATE ~ INSPECTO~ : SUFFOLK COUN'i'¥ HEALTH DEPARTMENT,, 'sINGE DWELLING ONLY .E FAMILY H.D. R~F. NO, TH~'SEWAG~, DISPOSAL AND WATER SUPPLY FACILITIES FOR THIS LOCATION ~HAVE BEEN ~INSPECTED BY THIS DEPARTMENT AND FOUND ~O ~BE' SATISFACTORY. ; , ,. Chi~ of w~st~e~e~ ~n~'~se'~'~on Approved 1. ~ ....19~.?. Permit No..t .~..'~J..~..~ Disapproved a/c ..................................... ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH o 3 SETS O~F.~?LANS o ~-~-'~. TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL $OUTHOLD, N.Y, 11971 NOTIFY TEL.: 765-1802 CALL - ;~-,ff-~(';~- -L~-O~'-<:~- · · MAIL TO: Date ............... 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 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 ova 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 cod~, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe~z~- ,,,,~~ ~ig,qature of applicant, or n~.me, if a corporat'on) ..... (Mailing address of applicant) State whether applicant is owner, lessee.~--agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises. ~/.~...Fo..~../.~. ~ .~.& .~. / ................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co¢orate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... ~T~. ~ ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of Iand on which proposed work will be done ...................... ~ ........................... - ......... ............. ............. House Num bet Street Hamlet County Tax Map No. 1000 Section .... /../.~. ......... Block ...~. ............. Lot...~...~:.~.... Subdivision., .~/.~...~. ~/.'~...~/.~.~./~/. ..... Filed Map No..~ ....... Lot .¢t~/~..~.. (Name) 2. State existing use and occupancy of premises and intended nsc and occupancy ofl~roposed c,onstruction: a. Existing use and occupancy ......... ~ .... ~ ................... b. Intended use and occupancy .................................... - ................................ 3. Nature of work (check which a~plicable): New Building ..... · ..... Addition... ~. .. . teration .~....: ,..~... Repair .............. Removal .............. Demolition ........... i~, . ~he~k~ ............... ~.o~6.~ C~ escripIion i (D ) 4. Estimated Cost ........... /. ......................... Fee ...................................... i " (to be paid on filing this application) 5. If dwelling, number of dwelhngiumts ........ ./ ...... Number of dwelling units on each floor. If garage, number of cars .... i .,f-/,~.,'~ ......................................... 6. If business, commercial or mixe~l occupancy, specify nature and extent of each t, yp,e of use iiii'ii 7. Dimensions of existing structures, if any Front .... ~ ........ Rear .. ~,/. ~. ....... Depth .... ~ ....... ~z 2 ~ Number of Stories ~e~. Height ...................... ; ....................................... Dimensions of same structure wlith alterations or additions: Front ................. Rear .................. Depth ................... i · · Height ...................... Number of Stories ...................... --,8. Dimensions of entire new construction: Front .......... ~ ..... Rear .... ~.~...' ...... Depth .... /.~. ' N Height ........ umber of Stories .., 10. Date of Purchase ....... ~.~.c?..~ Name of~ormer Owner ...... 1 1. Zone or use district in which promises are situated ......... A~. ................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... .,?.o. .................... .. 13. Will lot be regraded ........ ! · · ,9 ....... ,..,,. ..... Will ex~s fill be removod fro~ premises: Yes No 14. Name of Owner of premisesdG/},.~ ./~./,,~..,~..~.. Address ,AG~.o~..,~F./. ~/~ff~Phone No.. ~ ~ 2: .¢".c).~. ~.. Name of Architect ..... ~F,%4M (-,"//.(: ' ~'~' rP'r~' 'c~' '~'~: .......... Address ................... Phone No ................ Name of Contractor .... Address Phone No ................ 15. Is this property located!within 300 fe~t of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trqstees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly alI buildings, whether existing or proposed, and~ indicate all s~t-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ............................ ~ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sig¢ing contract) above named· He is the ..................... : .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dqly authorized to perform or have performed the said work and to make and file this application; that all statements con[alned 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 Notary Public ...... ~ ...... ty HELEN K, DE VOE ............ NOTARY PUBL C, SMe of New York NO. 4707878 Suffolk ~un~_,~ ~ (Signature of applicant) Term Expires March 10,