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Home My WebLink About15910-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Budding Inspector Town Hall Southold, N.Y Certi[icate O/ Occupancy No Z16340 Date October 2~.1987 TttIS CERTIFIES that the braiding Accessory Locat~on of Property 920 MEDAY AVE. .. .. House No County Tax Map No I000 Sechou 113 . Block Subdivision TOLLEWDOD MATTITUCK Streef .............. Hamle~ 0 I ] ...Lot 04 . l p[o 60 & FdedMapNo.. !7.5. LotNoP/.O conforms substantially to the Apphcahon for Braiding Permit heretofore filed in this office dated Aprzl 6, I9817 pursuant towh~chBudd[ngPerm~tNo ..15910z .. dated Apri. 1 15, 1987 was msued, and conforms to all of the requxrements of the apphcable provisions of the law 'Ihe occupancy for wtuch tlus certfficate is ~ssued is .. Accessory gal.rag, e as applied for. The cerhficate ~s Issuedlto WILLIAM A. & ELLEN M. LAWRENCE of the aforesaid braiding Suffolk County Departr UNDERWRITERS CER PLUMBERS CERTIF] Rev 1/'81 lent of Health Approval TIFICATE NO CATION DATED: N/6 .............. N/A N/A '~ildlng lnspecto~ ........ FORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y. Certificate Of Occupancy No Z16341 Date October 28, 1987 THIS CFRTIFIL'S tl~at the building Add ~..t i on Location of Property 920 MEDAY AVE. H~)use No County Tax Map No 1000 Sect~ou I 13 Subd~vision TOLLEWOOD MATTITUCK Street Him/et .Block Otl .... Lot . 04. l p/o/ 40 Filed Map No ..17.5... Lot No p/o/.4.1 conforms substantmlly to the Apphcahon for Budding Permit heretofore filed in tiffs office dated April 6, 19~7 , pursuant to which Building Perlmt No .15..9 .l.OZ .... dated Ap r ~-I I 5, 1987 was lsst,ed, and conforms to all of the requirement~ of thc apphcabte provisions ot thc [aw Fhe oc~.upancy for which this certificate is issued ts Deck a~dit~an ¢o qgisting one.family dyell, zqg ~s.~p.R~!ed for. The certificate is issued to WILL IAM A .. of the aforesaid bLukhn~ Suffolk County Departii~ent of tlealtb Approval UNDERWRITERS CERTIFICATF NO PLUMBERS CERTIFICATION DATED: & ELLEN M. LAWRENCE N./A ............ N/A N/A B~ffd m g Inspector Rev 1/81 TOV/N 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) 15910~ Z D~e ............ /..~ ...................... 1~.~.7 Permission is hereby granted toL i .~.~,,,+ ................ ~/,~ ........... ..~...~.. .' ................ :"'!~i~.~" ~'"~'"'~";"'- .......... _ ..~.~ ...... :~ .......... .~. ................... , ,o -~~..-.-.~.~~..-.~.~,..~...'-.~...~.~...,~,~-'m County Tax Map No i000 Section ...... IJ~...~. ....... Block ..... ..C~..'.J...J. ........ Lot No ...~..~.: .! ...... pursuant to application dated ...... .~.. ........................ , 19~."].., and approved by the Building Inspector. Rev. 6/30/80 TOWN OF $OUTHOLD i ~//~ ~ j Building Depa.ment J 2 6 I/ Southold, N.Y. 11971 ~'Oj ~PLICATION FOR CEBTIFICATE OF OCCUP~~LD Instructio~s A. This apphcat~on mu~ be fdled in Wpewrlter OR ~nk, and subm~ed II to the Budding In~ec- tor w~th the following; for new buddings or new use. 1. Final ~ey of prOpe~ with accurate location of all buddings, prope~y lines, ~reets, and unumal na~ral or topographic features. 2.FmaI approval of HeaJth gept of water supply and sewerage dJsposai-(S-g form or equal). 3.Approval of electrlcal mstallaUon from Board of Fire Unde~mters. 4. Commermal braidings, Industrial buddings, Multiple Residences and similar buildings and in~alla- tions, a ce~fJcate of Code compliance from the Architect or Engineer re~ons~ble for the building. 5.Submit Planning Board approval of completed site plan requirements where apphcable. B. For existing buddings (prior to Aprd 1957), Non-conforming u~s, or braidings and "prmexl~ing" land uses: 1. Accurate ~ey df p~pe~y showing all properW lines, ~reets, buildings and unu~al natural or topographic features. 2.Sworn statement df owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safe~ inspection of buddings or premises, or other pe~lnent reforma- tion required to prepare a ce~Jflcate. 1. C~lflcate of occupancy Ee~ D~e[[~ ~ZS.00, ~so~ ~us~ess ~50.00 2. Ce~[fmate of~ccupancy on pre-existing dwelling S 50. ~ 3. Copy of certlflCate of occupancy $ 5 00~ ove~ 5 ~ea~s ~]0.00 4.Vacant Land ,C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..~ ............. Newconstruction ~ .... OIdorPre-exlstmgB~dd[ng ......... Vacant Land .......... Owner or Owners of Pro~e~ .............. z ........................................ County Tax Map No 1000Section ...//~ ....... B)ock .............. Lot. ~'~ Subd~ws~on ........ t ................. Fded Map No ......... Lot No ............ Health Dept Approval .................... Labor Dept, Approval ........................ Underwriters Approval , ~ ................... Planning Board Approval ...................... Request for Temporary Certificate .................. Final Certlhcate ....................... FeeSubm~tted$ .. . , ................. Construction on above described bud ng and permit meets all app cab e codes and regulat ohs. , ~ppHcan~ . ~'".'~ ........... 5 .......................... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcat~on must be filled m typewriter OR ink, and submitted t I~.~ to the Building Inspec- tor w~th the following, for new buddings or new use' 1. Final survey of properW 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 dmposel-(S-9 form or equal). 3. Approval of electrical ~nstallat~on from Board of Fire Underwriters. 4. Commercial buddings, Industmai buddings, Multiple Remdences and similar buildings and installa- tions, a certWmate of Code compliance from the Architect or Engineer responmble for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buddings (pmor to Aprd 1957}, Non-conforming uses, or buddings and 'pre-existing" land uses: 1. Accurate survey of pZoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement df owner or prewous owner as to use, occupancy and condmon of buddings. 3. Date of any housing code or safety ~nspect~on of buddmgs or premises, or other pertinent reforma- t,on requ,red to p~epare a~ $25.00 ecs ltlOnS 1. Certlficate of occupancy New~ui%Zno $25.00, Accessory ,$t0.00 Business $50.00 2. Cerhhcate of occu'pancy on pre-exmtmg dwelhng $ 50.00 3 Copy of certW~cate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land 'C.O. $ 20 00 /._/.,/,?.~,/../.~/.~.. 5.Updated C.O. $ 50.00 Date ....................... NewConstruction ' . .. OldorPre-exlst~ngBuddmg . Vacant /¢ ~ ~ g~ /.~,~ ..... Land ............. House No. Street Nam/et Owner or Owners of Property . . .~.~.~..w.,~..,~. ~ ,~ ..~..~.+~..,~..../~..,..~.~../~...,~.~..,~.~.~.=~. ....... CountyTax Map No. 1000 Sect,on ..././.-~. .... Block ...././~.~. ...... Lot Subd~wmon ...... r ............ Fded Map No .......... Lot No ............. Permit No./..~./.0.. ~v"... Date of Permit ....... Apphcant ...... .~../..~. .................. Health Dept. Approval .................. Labor Dept. Approval ....................... Underwmters Approval ..................... Planning Board Approval ..................... Request for Temporary ~erUflcate ..................... F~nal Cert~hcate ...................... Fee Submitted $ '--' Construction on above described budding and permit meets all apphcable codes and regulations Apphcant ~_/.~¢'/¥' Rev 10 10 78 /~'~./~ ~/~.~, ~ , OUNDATIO:~ / { lst)~ OUI~DATION { 2nd ) OUGH FRAME & ?LUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL ~ENTS: 765-1802 iBUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~r~NAL REMARKS: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FO/uD ATION IST [ ] ROUGH PLBG. ATiON ZND [ ] INSULATION FRAMING £ ] FINAL DATIr ~///~.7 ,NSpI:'CTO~R ~ ~ Examined .~ I~--...,198q Approved . c~ .) ~'. Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N Y. 11971 TEL.: 765-1802 , 19~~ Permit No /~'9! ~.~' (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG, OEP'r /'TO~ OF SOU'i'HOLD Received ........... ,19.. Date .. 9. a Ttus apphcation must be completely filled tn by typewnter or m ink and submitted to the Bmldmg Inspector, wttb 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 stre. or areas, and glvmg a detmled d~scnptlon of layout of property must be drawn on the diagram which is part of this apt cation c. The work covered by tins application may not be commenced before issuance of Bufldmg Permit d Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant Such pent shall be kept on the premises available for mspection throughout the work. e. No buildmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmlding Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal, or demolition, as hereto describ. The applicant agrees to comply with all apphcable laws, ordmances,.b,,~llt~,eode/fiousmg)2Od~, and regulations, and admit authorized inspectors on premises and m building for necess~g~-'/9~n%/~ ~ ~l/. ×,./(Slgna/m~ of a~l)c~h~ o~r name, if a corporation) ..... ....... , ... C ................. /7../A~; :;./ .... ././.'..~.. ' (mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Name of owner of premises If applicant is a corporation, signature of duly authorized officer N 1 I (ame and tit e of corporate officer) Builder s License No Plumber's License No ... Electrician's License No Other Trade's License No (as on the tax roll or latest deed) 2 Location of land on which proposed work will be done House Number Street County Tax Map No 1000 ~ection //~. I (Name) Hamlet ' ' · Block ~// .... Lot '~' / Filed Map No /?..4" Lot State ex,sting use and occupancy of premises and intended use and occupancy of proposed construction ' a. Exlstlnguseandoccupan_cy / ./~w.4~. ,~ .......... b Intended use and occupancy K~///2~'~.~..~y>-/~v~-~'~- -- ./~.~.~./0.~-..,~.~?:~. 3 Nature ofworkZch,e.~ w~Tt'applicable) /~/ew Building ..v~.... Add, tmn ..... Alteration .l-~.... Repaxr ~.~.~ ~.~. ?$~oval . .~ ....... Demohtmn .......... OtherWork .... ..... ~ _~ ~ (Description) 4. Est~ated Cost ~.,~ ~ ~ ................ Fee .............................. ........ (to be prod on filing this application) 5. If dwelling, number of dwelhng umts .......... Number of dwelhng units on each floor ............ If garage, number of c~s .... ~ ................................................ 6 If bus~ness, commerm~ or m~xed occupancy, specify nature and extent of each type of u~ ................ 7. D~ensmns of ex~st~ng structures, if any Front .. . Rear .......... Depth .......... Height .......... Number of Stones ~ ~F~s~ons of sine stmct~e w~th flterat~ons or add~tmns Front ............ Rear ..... ~tfi..: ........... ~ . .Hm~t ....... ; ...... Number of Stones ............... 8 ~ensmns of entire new e~nstmctmn Front ... g~ .... Rear ...~ ~ ..... Devth .. ~./ .... e}gh~ ~ .: ~umber of Stones .......................... 9. .z~ o~ront ,--~ ~q .... Re~. /~' . ...... Depth .. /~.~ ........ ...... . . . 1 ~ ~o-0~ ~smct m ~F~el~vicmt~e~ are s~tuateO ~:;~F/4.& .................. 12. D6~ p~op~sed construcff~%mlate any zomng law, mdxnance or re~lation' . ..................... ~ 13. Wflllotberegraded ~ ) ..... ~.. ..... =Wa~exces~fillberemovedfrompremmes' ~s ~ 14. NmeofOwnerofpremases/ffS~/~~ddress ...~ ..... Phone No ~' ~ Nme of Archstect .................. Address ........ Phone No ....... N~e of Contractor ................ Address ........... Phone No . .,~ ..... I5. Es thza property Zocated wSth$nl00 feet of a tidal wetland~ * Yea ..... ~o ~... · If yes, Southold To~ Trustees Permxt may be requ&red. PLOT DIAG~ Locate clearly ~d d~stlnctly ~ buildings, whether exmt~ng or proposed, ~d, md~cate ~I set-back d~ensmns fro prope~ hnes. G~ve street and block number or descnptmn according to deed, ~d show street nines ~d ~dmate whetb mtenor or corner lot STATE OF NEW YORK, COUNTY OF. SS (Name of lndlwdual signing contract) above named bmng duly sworn, deposes and says that he is the apphca He is the (Contractor, agent, corporate officer, etc ) of sad owner or owners, and is' duly authorized to perform or have performed the sa~d work and to make and file tl apphcatmn, that all statements contmned m this application are true to the best of h~s knowledge and belief, and that t work wdl be performed In the manner set forth m the apphcatmn filed therewith. Sworn to before me this occu,^NcY o. USE IS UNLAWFUL WITHOUT CERTIFICATE ~'~" ~CCUPANCY plo LOT ~1 ~ p/O LOT plO i.01' ~0 1596 ~ ~ RIV~RN~ '/.~- o '~ ~ LOT ?/0 ) V~. LY. 1190/ COM~NY 07'107591 SURVEY OF PlO LOT ~0 ~ PlO LOT ~/ MAP OF TOLLE~OOD ~ M~T/~UCK TO~ OF ~OUT~O~ pre~Gred ~n a~ordance wi~ ~e mm~um SUFFOLK COUNT~ N,~ alandard~ for fine ~eyl m ~blished by T~ ~ ~ ~/0~ '//~' ~/' ~. / tho L.I.A. L, S. ~d app~ ~d odopte ~L~: /'~20 ~ for au~h um by The N~ Yo~ S~te Land Title A.oclatton. WILLIAM A. LAWRENCE ELLEN Itl. LAWRENCE r 85-2/4 A Mx~ Y ~0,1985 SEPT il, 1987 REVISION 4 - 29 - 86 m 4VF_.NUE' N DECK WEW B1£60 Io.o · E~VTRY ~ /~ TO"X I~' GARAGE Z~-'VJ x 30~D FRAME lb" 0 C, COMCRETE BL~K TO ~E FOUMDATION(3 HIGH) REMOVEO ~'wooo WALLS WITH L~ 51DING I' OPEN RAFTER TALL3 ACT. gOT 41 p/O SURVEY OF ¢£B T/Fl ED ¢O m'P,41V F Wl LLI,4M TO: ?/TLE INSUR,4 NCE' 07-107~;91 SUFFOLK COUNT~ fl.K ~'"'"'"'"'"'""~ " m~ m a~cordance with the ~i.imum ~~: /¢¢=~0~ "andords for hfle su~eys .s e~tabhshed by M~ Y ~0, 19~5 the L I.~ L. S. and approved o.~ ~dopted for ~uch u~ by The New Yor~ ~t~te ~ Title ~oc~afion. 65-214