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Home My WebLink About16221-zFORM NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.-x 169.9.1. ....... Date ...... J. tlo e..1.4,.. 9.8.8 .......... THIS CERTIFIES that the building ADDITION 235 Deer Path Mattituck, N.Y. Location of Property .......................... House No. ' '' ' 'S't/e~; ....................... h~le~ County Tax Map No. 1000 Section . . 1. 0..6 ....... Block . . . 1. 0. .......... Lot .... 2. .8 ...3 ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 16221 z July 8, 1987 pursuant to which Building Permit No .... ; ................. dated.... ..... Ju. ....... 17 13 ,..1 ......... 987 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 ......... ADDITI6N TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR' The certificate is issued to JOSEPH MOISA JR. & CATHERINE MOISA ..................... io¥,,'o;,'t~Y~Xi~}~: .................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. PENBING - May 23, 1988 June 7, 1988- Joseph Moisa Jr. PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 I~ORM NO. ~ TOWN OF $OUTIiO£D BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ('rills PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 16221 Z Permission is hereby granted to: T::;..u...: ..... ~.......;: ........................ .~ ................ ........... rP.....'...~...../ .......... ~ ...................................... ............ .......... .......... .... ot premises Iocote~d at .....'~...~..~,,...~...,~.~......~~ ......................... County Tax Map No. 1000 Section ...... I...O....('R ....... Block ...... }...0. ......... Lot No....~,.~...:.?'~ ....... pursuant to application dated ........ .,,~.~,,~ ........................, ! 9.1..'~., ond approved by the Building Inspector. Fee $...~.. ................ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of p~operty 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 certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Ce~tificateofoccupanc¥ New Dwelling $25.Q0, 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.C. $ 20.00 (P./.~.~.~.~'/~ 5.Updated C.C. $ 50.00 Date ....................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ' o House No. , /~ Street ;Yam/et Owner or Owners of Property County Tax Map No. 1000 Section /O ~ Block ]..~. Lot..~. ,~.~.~. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ) ~ ."~.~ . Date of Permit .......... Applicant ............... .~..O.{5'./y....~..~.~.-.... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building,~5'~ermit meets a~ applicable co~s and regulations. Appl ican~~...~~. ~. ..................... Rev, 10-10-78 ;6qql TO~;N OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~/ Owner ~ ~1~ ~+ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s slg~re~ Sworn to before me this 7th day of June , 19 88 . Notary Public, Suffolk County Notarg Public M~/AN~ V. B~OWN No~ P~.l% State of N~ Yo~ No, 4~12 ~m~l~ ~ ~ 19, 19~ OUN~{~ __ 1st) OUNDATION ( 2nd ) OUGH FRAME PLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE FILIAL, ADDITIO~;~L 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: 'FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ~FRAMING [ ] FINAL REMARKS: , ,INSPECTOR ?~ ~ 7GS-Z.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION ZND FRAMING REMARKS: ROUGH PLBG. I/NSULATION /~/FINAL 765-181)2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND £ ] INSULATION FRAMING [/~] FINAL /~/~ 765-1802 ~/~ BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION FINAL ? 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALl_ $OUTHOLD, N.Y. 11971 TEL.: 76§-1802 SURVEY , C ECE SEPTIC FORM ............. : Examined.. ~. ~ l.~ .., 19 .~J. Approved ...... !.~.., 19~. ?. Permit No..l..~..~.~...I..~. Disapproved a/c ..................................... ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT NOTIFY CALL ................ MAIL TO Date .~.52.. 7 .' ....... 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 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 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, ordinan, gces,?y, o~ilding code, housing code, and re/g~ions, and to admit authorized inspectors on premises and in building for nece/fsary inspections/ ~, / / ...... ;.., .... (Signature of applicant, or name, 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~c//d/4~.~. · .~. e/~. - ·e~.' · '(~as :o~' t'~ia'x'~'~c~dd)~ .................. If applicant is a corporation, signature of duly authorized officer. (Name and tide of corporate officer) . ALL CONTRACTOR'S MUST /B~ SUFFOLK COUNTY LICENSED Builder's License No ....... / .... ~. ~5-/....~...~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location,~of land on which proposed w~ork will be dongs, .......................... , ....................... . ...................... ! ............ ................ House Nmnber Street Hamlet County Tax Map No. 1000 Section .. ]9.6 ........... Block ... I.O ............ Lot.. ~t'..X. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: /."-~. E'...¢ ~ P. 4S.,.,.,.,.,.,.,., .x~.:/.,4. a. Existing use and occupancy . ' ' . ..... b. Intended use and occupancy /.~ E'¢JD.. ·F. .t~./.· .&-. ·. 3. Nature of work (check which applicable): New Building .... Addition ...... Alteration .......... Repair ..... ..~ ...... Removal .............. Demolition .............. Other Work ............... 4. Estimated cos; .... t ........ , ......................... Fee ............. i' " (to be paid on filing this application) 5, If dwelling, number of dwetlingiunits ....... l ....... Number of dwelling units on each floor ...... ] .......... ' If garage, number of cars .... i · ~ ........................................... ,.' ........'. ~ ........... 6. If business, commerciafor mixe~l occupancy, specify nature an, d extent of each tygejof use .. :5. i :'.'. ............. · io ' ' ructu ; if an · . 26,,~ ~ ,t:[ De ego ' 7. Dtmens ns of~existmg st res~ y. Front .............. ~./. . Rear .... (o ......... ~ ;pth.... '~. ~ ........ Dimensions'of same structure wiith alterations or additiops: Front ...... .~'.//?/ ...... Rear .. ,.,.~.].t.cJ .......... Depth ....,0.. ~J,,~ ........... ~.. Height .... ~..O...Q...~. ', ....... Number of StoNes .... ] ff. ;h~ ............ "8. Dimensions of e~ir? new construction: Front ..... .~.~.' .Q ....Rear ..... ~,~,. 0 .... Depth ...(~..~,.~ Height ..... /.,~,.O. ...... Number of Stories ..... / .......... ,.i ....................................... 11, Zone or use district in which premises are situated ..... /.<.~./.0.~:o. 7/.~. ................................... 12. Does proposed constrnction violate any zoning law, ordinance or regulation: ....... ~/.0. ..................... 13. Will lot be regraded ..... t~.q ................ Will excess fill 1~ remove~from premises: Yes Nme of Architect ......... i ................ Address ................... Phone No. . 15. Is this property locatedlwithtn 300 feet of a tidal wetland? ayes ..... No ~.... · If yes, Southold Town Trustees Permit maybe required. I PLOT DIAGRAM Locate clearly and distinctly ali l~i~lii~, whether existing._or~propose, d, and. indicate all set-backdimensions from l~roperty_ lines. Give street and block~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, I S.S COUNTY OF ............. , ............................ i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named, l He is the ..................... i ............................................................. ' ....... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dtdy 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 mannler set forth in the application filed therewith. Sworn to before me this ............... · ~. ....... day~f .... ~ ............ 19 .°~t ..~ Notary Public, . ~ ~1.' ~ ~.~...~P~. Co~'~ Term Expires Msreh 30,19. o ! ~ ,,o,s,,,.,~.,,., ,,,, -l~,,,~- .,