The URL can be used to link to this page

Home My WebLink About15656-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy Z- 15235,~ Date February 2, 1987 No. THIS CERTIEIES that the building ..... DECK ADDITION Locat~on of Property 645 WICKHAM AVENUE MATTITUCK, NEW YORK House No. Street Ham/et County Tax Map No. 1000 Sechon . 14 0 .Block 2 ....... Lot 2 7 Subdivmlon.. ~ Filed Map No .Lot No. conforms substantially to the Apphcahon for Building Permit heretofore filed in this office dated J.a.n.u.a..ry .2.8. :. .I.~8.7 .... pursuant to winch Bualdmg Permit No ...1.56..5.6.Z. ......... February 2, 1987 dated ...... , .......... , was msued, and conforms to all of the requirements of the apphcable provisions of the law The occupancy for winch tins certificate is msued ~s ........ DECK A~DITION TO EXIS, TING ONE FAMILY DWELLING TIMOTHY J. & BARBARA S. BRIGHAM The certificate m lsshed to ..................... (owner, ~ of the aforesmd building. N/A Suffolk County Department of Health Approval ..................................... N/A UNDERWRITERS CERTIFICATE NO ......................................... PLUMBERS CERTIFICATION DATED: Rev 1/81 N/A Building Inspector J'OII, M NO. ~1 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) NB 15656~ Z Permission is hereby grented to: , ...~.~.~.....~.~."/.'//."~i[ ...... ....~.~.~,~....~..:~..,......l.~..?..~)..... ....... ~'"~'""""'"'~~'""~':":""¥-,, ............ n':::':'"~"-_'"'~:~ ............ at premises located at ......... ..~.~... ......... (~...~....~...~....~ ...... :_'....}..~ ................. pursuant to application dated .....~~........'~. ~"~/ -' .... BuiJdlng inspector, Fee $..~....: .......... ...... , 19..~ .~., and approved by the Rev 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hal; Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY J/ l 2 8 a87 Instructions A. This epphcatton must be filled tn Wpewnter OR ink, and submitted ~m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of prbperty with accurate location of all buddmgs, property lines, streets, and unusual natural or topographic features. 2. F~nal approval of Health Dept of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical mstallat~on from Board of F~re Underwriters. 4. Commercial buddings, Industrial buddmgs, Multiple Residences and s~milar buddings and installa- tions, a certificate of Code comphance from the Architect or Engmeer responsible for the bufldmg. 5. Submit Planmng B,oard approval of completed s~te plan requirements where applicable. B. For existing buddings (prior to April 1957), Non-conforming uses, or bufldmgs and "pre-existing" land uses' 1. Accurate survey of property showmg all property hnes, streets, buildings and unusual natural or topographic features 2. Sworn statement ~f owner or previous owner as to use, occupancy and condition of bullrings. 3. Date of any houmgg code or safety inspection of bufldmgs or premises, or other pertinent informa- t~on required to prepare a certificate. C. Fees' 1 Certificate of occupancy Neu D~cellins $25.O0, Accessory ,$ t0.00 Business $50.00 2. Cert~fmate of occupancy on pre-existmg dwelhng $ 50.00 3 Copyofcertlflcate'ofoccupancy $ 5.00 over 5 , $ ~0,.00 / 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..................... NewCons%z~uct,zon ...... Old or Pre-ex~stin)g Budding .... ~ ..... Vacant Land ............. Location of Property..& ¢.~. .... .~../.~..E~./~./~. .... ~,~.~ ..... ~ .~. ~..! Owner or Owners of Property .. ~.~/t~L~..~)...~.... ~%_~..~.~.. .... County Tax Map No 1000Sect,on ...f..Z~..O .... ~... Block ...~. ......... Lot .?~.~ ........ Subdw~s~on ...................... Filed Map No .......... Lot No ........... Permit No .......... Date of Permit .......... Applicant. ................................ · Health Dept Approval ........................ Labor Dept. Approval ........................ Underwriters Approval Planning Board Approval .... Request for Temporary Certificate .Fmal Certificate ..... Fee Submitted $ ........................... Constructmn on above described budding and permit mee[s all apphcable codes and regulations. Rev 10-10 78 Iisi 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION [ ] FRAMING REMARKS: (~/~ [ ] ROUGH PLBG. ZND [ ] INSULATION FINAL INSPECTOR~ D~approvcd a/c ........ I .... BOARD OF 3 SETS FORM NO. I SURVEY TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC TOWN HALL $OUTHOLD, N.Y. 11971 TEL.. 765-1802 CALL MAIL HEALTH OF FORM (Bmldmg Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ........ 19 a. Tlus apphcatlon must be completely filled m by Wpewnter or an ank and submatted to the Building Inspector, wath 3 sets of plans, accurate plot plan to Jcale. Fee according to schedule b Plot plan showmg locaUon [of lot and of bufldmgs on premases, relatmnsh~p to adjoining premases or pubhc streets or areas, and g~vmg a detailed des'c~p'"ht~n of layout of property must be drawn on the dmgmm which ~s pa~ of th~s apph cat~on. . ..~'I c. The work cgv~d~t~tlon~ hbt~e commenced before lSSU~Ce of Building Permit. d. Upon appr~al ofl~[~a~iJ~dmg Inspector will ~ssued a Budding Pemzt to the apphcant Such pe~t sh~ be kept on the premts~vaflable for m~e~ion ~rou~out the work. e. No bufldmwsha~b~&~p~d,~ [sedln whole or m p~t for any purpose whatever unffi a Ce~fficate of Occup~cy shall have been g~ted ~ t~e Bmld~ ~PLICATION IS HER~Y ~AD~ to the Buddmg Dep~tment for the ~ssuance of a Bmld~ng Pe~t pu~uant to thc Bmldzng Zone Ordinance of ~e~own of Southold, Suffolk County, New York, ~d other apphcable Laws, Ordm~ces ox Regulatmns, for the construction of buildings, additions or alterahons, or for removal or demolition, as hereto described The apphcant agrees to comply w~th a~ apphcable laws, ordinances, building code, housing code, and reg~atmns, and tc admzt authored mspectom on pre~zses and m budding for necessa~ ms~ect~s. - %- ........... -- ($zgnature~f ~psh~ame~ ff a corporatmn) / ~ t (Mamng address or appncant) State whe~er apphcant m owner} lessee, agent, ~ch~tect, en~neer, general contractor, electrician, plumber or builder Nme of owner of premises , at de If apphcant ~s a corporatmn, sxgnature of duly authorized officer (Name and tatle of corporate officer) Builder's hcense No ~ Plumber's L~cense No Electrician's License No Other Trade's License No Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Sectlon [t~b Hamlet Block ...~. ...... Lot .~ r7 Subdivision .... Filed Map No .. Lot ......... (Name) State existing use and occupancy of premases and intended use and occupancy of proposed construchon a Exlstmg use and occupancy DOTs' /) i... oD r) ........... b Intended use and occupancy .................... 3 Nature of work (checkwhlch, applicable) New Building . Addition ....... Alteratzon Repair .... I Removal ....... Demolition ....... Other Work ....... ..~/_2 . ~ (Description 4 Estimated Cost '~;(/.~.~- ?. ¥..~. ............... Fee~ ...................... (to be paid on filing this appl,catlon) 5. If dwelhng, number of dw,elhng units .......... Number of dwelling units on each floor .......... If garage, number of cars I ................................................ 6 If business, commercml or'Imlxed occupancy, specify nature and extent of each type of use ...... 7. Dimensions of exmtlng structures, if any Front ..... Rear ......... Depth Height .. I Number of Stones Dimensions of same struc[ure with alterations or additions Front ............. Rear .... Depth .... ! . Height ......... Number of Stones ............... -'-8. Dimensions of enbre new construction. Front ............... Rear ............... Depth ............ Height ....... ~l Number of Stones ........................................ 9 Size of lot Front '1 ....... 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 .................... 13. Will lot be regraded I Will excess fill be removed from premises Yes 14. Name of Owner of premises ............ Address ............ Phone No ............ Name of Arctutect ..... I, . .............. Address ........... Phone No ......... Name of Contractor ............... Address ........... Phone No,.,. . 15. Is thzs property located within 300 feet of a tmdal wetland? *Yes ..... No ..~. *If yes, $outhold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dimensions fr property hnes. Give street and block number or descnption according to deed, and show street names and indicate whet mtenor or comer lot OCCUPANCY OR USE IS UNLAWFUL WiTHOIJT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED ~. ~' ~ ~v- ~,6'-L. ~OTI~ BUILDING DEPARTM~ AT ~65 1802 9 Ae~ TO · ~M ~R ~E FOLr CWt~,lfl {NqPECTION~i FO~ POU~b ,'0~(~1 ~ t'~ ~ObO~ ~'~A;~IN~ ~ P~.oMBING ALL ,C: '? ,~IOCTION SMALL MEET ST~ Tt CONSTRUCTI~ & EklERGY ~E~!~r~ e2~t C~qSTRUCIlON ~RRORS STATE OF NEW_YORK ..... COUNTY O..F .%-.'~. ~ k, l?._ ~ ~ .~ [~~~[,,~,,1~ V~ ~: k,~~~--~~~__ l: being duly sworn, d epo ses and says that he 1S the apphc d tracti ' above named ('- -'-% .e: th ...... (Contractor, agent, co,orate officer, etc ) of said owner or ownem, ~d ~s duly authomed to perform or have perfo~ed the sa~d work and to m~e and rite · apphcatmn, that all statements .contained m thru apphcatmn are true to the best of h~s knowledge and behef, and that work wfli be perfo~ed ~n the m~ner set forth m the apphcanon filed therewith. /y~ g (Signature of apphc;